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18 Marzo 2022
Charles N Ellis, Stephen J Neville, Mohamed Sayyouh, James T Elder, Rajan P Nair, Johann E Gudjonsson, Tianwen Ma, Ella A Kazerooni, Melvyn Rubenfire, Prachi P Agarwal

Epicardial adipose tissue volume is greater in men with severe psoriasis, implying an increased cardiovascular disease risk: A cross-sectional study

J Am Acad Dermatol. 2022 Mar;86(3):535-54

Key messages

  • I pazienti di sesso maschile affetti da psoriasi senza malattia coronarica o diabete noti hanno mostrato volumi di tessuto adiposo epicardico maggiori rispetto ai controlli sani.
  • I volumi del tessuto adiposo epicardico possono rappresentare un marcatore precoce per identificare i pazienti con un aumentato rischio cardiovascolare.

Abstract

Background
Patients with psoriasis have elevated risk of coronary artery disease.

Objective
Do patients with severe psoriasis have larger epicardial adipose tissue volumes (EAT-V) that are associated with cardiovascular risk?

Methods
For this cross-sectional study, we recruited dermatology patients with severe psoriasis and control patients without psoriasis or rheumatologic disease themselves or in a first-degree relative. Participants aged 34 to 55 years without known coronary artery disease or diabetes mellitus underwent computed tomography (CT); EAT-V was obtained from noncontrast CT heart images.

Results
Twenty-five patients with psoriasis (14 men, 11 women) and 16 controls (5 men, 11 women) participated. Groups had no statistical difference in age, body mass index, various cardiovascular risk factors (except high-sensitivity C-reactive protein in men), CT-determined coronary artery calcium scores or plaque, or family history of premature cardiovascular disease. Mean EAT-V was greater in the psoriasis group compared to controls (p = 0.04). There was no statistically significant difference among women; however, male patients with psoriasis had significantly higher EAT-V than controls (p = 0.03), even when corrected for elevated high-sensitivity C-reactive protein (p = 0.05).

Limitations
A single-center convenience sample may not be representative.

Conclusion
Males with psoriasis without known coronary disease or diabetes had greater EAT-V than controls. EAT-V may be an early identifier of those at increased risk for cardiovascular events.

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