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Cumulative inflammatory burden is independently associated with increased arterial stiffness in patients with psoriatic arthritis: a prospective study.

Shen J, Shang Q, Li EK, Leung YY, Kun EW, Kwok LW, Li M, Li TK, Zhu TY, Yu CM, Tam LS - Arthritis Res. Ther. (2015)

Bottom Line: PsA patients were divided into two groups based on whether their PWV value is ≥1450 cm/s (High PWV group, N=38) or <1450 cm/s (Low PWV group, N=34).The High PWV group had a significantly higher ca-ESR (29 (19 to 44) versus 18 (10 to 32) mm/1st hour, P=0.005) and ca-CRP (0.7 (0.3 to 1.4) versus 0.4 (0.2 to 0.7) mg/dl, P=0.029).Using regression analysis, high ca-ESR (defined as ≥75th percentile: 37 mm/1st hour) was associated with a higher likelihood of being in the High PWV group (odds ratio (OR): 9.455 (1.939 to 46.093), P=0.005, adjusted for baseline clinical and cardiovascular risk factors; and 9.111 (1.875 to 44.275), P=0.006, adjusted for last visit parameters).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. shenjiayun@hotmail.com.

ABSTRACT

Introduction: The aim of this study was to examine whether the cumulative inflammatory burden is associated with an increase in arterial stiffness in a prospective cohort of psoriatic arthritis (PsA) patients.

Methods: In total, 72 PsA patients were followed for a median of 6.5 years. Cumulative inflammatory burden was represented by the cumulative averages of repeated measures of erythrocyte sedimentation rate (ca-ESR) and C-reactive protein (ca-CRP). Brachial-ankle pulse wave velocity (PWV) was measured at the last visit. We also included 47 healthy controls for PWV assessment.

Results: PWV was significantly higher in PsA patients compared with healthy controls after adjustment for age, gender and body weight (1466±29 cm/s versus 1323±38 cm/s, P=0.008). PsA patients were divided into two groups based on whether their PWV value is ≥1450 cm/s (High PWV group, N=38) or <1450 cm/s (Low PWV group, N=34). The High PWV group had a significantly higher ca-ESR (29 (19 to 44) versus 18 (10 to 32) mm/1st hour, P=0.005) and ca-CRP (0.7 (0.3 to 1.4) versus 0.4 (0.2 to 0.7) mg/dl, P=0.029). Using regression analysis, high ca-ESR (defined as ≥75th percentile: 37 mm/1st hour) was associated with a higher likelihood of being in the High PWV group (odds ratio (OR): 9.455 (1.939 to 46.093), P=0.005, adjusted for baseline clinical and cardiovascular risk factors; and 9.111 (1.875 to 44.275), P=0.006, adjusted for last visit parameters).

Conclusions: Cumulative inflammatory burden, as reflected by ca-ESR, was associated with increased arterial stiffness in PsA patients even after adjustment for cardiovascular risk factors, emphasizing the important role of chronic inflammation in accelerating the development of cardiovascular risks in PsA patients.

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Pulse wave velocity (PWV) in control subjects and patients with psoriatic arthritis (PsA). (A) Unadjusted mean in control subjects (n = 47) and all PsA patients (n = 72). (B) Mean adjusted by age, gender and body weight in control subjects and all PsA patients. (C) Mean adjusted by age, gender and body weight in control subjects and PsA patients without hypertension, diabetes or hyperlipidemia (n = 20).
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Fig1: Pulse wave velocity (PWV) in control subjects and patients with psoriatic arthritis (PsA). (A) Unadjusted mean in control subjects (n = 47) and all PsA patients (n = 72). (B) Mean adjusted by age, gender and body weight in control subjects and all PsA patients. (C) Mean adjusted by age, gender and body weight in control subjects and PsA patients without hypertension, diabetes or hyperlipidemia (n = 20).

Mentions: The mean PWV in PsA patients and control subjects were 1,533 ± 307 cm/s and 1,219 ± 157 cm/s, respectively (P <0.001) (Figure 1A). The control subjects were significantly younger (43.1 ± 10.2 years versus 55.9 ± 11.6 years, P <0.001), had higher proportion of women (72.3% versus 50.0%, P = 0.015) and a lower body weight (58.2 ± 8.7 kg versus 65.7 ± 11.6 kg, P <0.001) at PWV assessment compared with the PsA patients. However, after adjustment for age, gender and body weight, the adjusted mean PWV was still significantly greater in PsA patients compared with control subjects (1,466 ± 29 cm/s versus 1,323 ± 38 cm/s, P = 0.008) (Figure 1B). If patients with hypertension, diabetes or hyperlipidemia were excluded, the age, gender, and body weight-adjusted mean for PsA patients (n = 20) and control subjects were 1,394 ± 46 and 1,248 ± 29 cm/s, respectively (P = 0.013) (Figure 1C).Figure 1


Cumulative inflammatory burden is independently associated with increased arterial stiffness in patients with psoriatic arthritis: a prospective study.

Shen J, Shang Q, Li EK, Leung YY, Kun EW, Kwok LW, Li M, Li TK, Zhu TY, Yu CM, Tam LS - Arthritis Res. Ther. (2015)

Pulse wave velocity (PWV) in control subjects and patients with psoriatic arthritis (PsA). (A) Unadjusted mean in control subjects (n = 47) and all PsA patients (n = 72). (B) Mean adjusted by age, gender and body weight in control subjects and all PsA patients. (C) Mean adjusted by age, gender and body weight in control subjects and PsA patients without hypertension, diabetes or hyperlipidemia (n = 20).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4384323&req=5

Fig1: Pulse wave velocity (PWV) in control subjects and patients with psoriatic arthritis (PsA). (A) Unadjusted mean in control subjects (n = 47) and all PsA patients (n = 72). (B) Mean adjusted by age, gender and body weight in control subjects and all PsA patients. (C) Mean adjusted by age, gender and body weight in control subjects and PsA patients without hypertension, diabetes or hyperlipidemia (n = 20).
Mentions: The mean PWV in PsA patients and control subjects were 1,533 ± 307 cm/s and 1,219 ± 157 cm/s, respectively (P <0.001) (Figure 1A). The control subjects were significantly younger (43.1 ± 10.2 years versus 55.9 ± 11.6 years, P <0.001), had higher proportion of women (72.3% versus 50.0%, P = 0.015) and a lower body weight (58.2 ± 8.7 kg versus 65.7 ± 11.6 kg, P <0.001) at PWV assessment compared with the PsA patients. However, after adjustment for age, gender and body weight, the adjusted mean PWV was still significantly greater in PsA patients compared with control subjects (1,466 ± 29 cm/s versus 1,323 ± 38 cm/s, P = 0.008) (Figure 1B). If patients with hypertension, diabetes or hyperlipidemia were excluded, the age, gender, and body weight-adjusted mean for PsA patients (n = 20) and control subjects were 1,394 ± 46 and 1,248 ± 29 cm/s, respectively (P = 0.013) (Figure 1C).Figure 1

Bottom Line: PsA patients were divided into two groups based on whether their PWV value is ≥1450 cm/s (High PWV group, N=38) or <1450 cm/s (Low PWV group, N=34).The High PWV group had a significantly higher ca-ESR (29 (19 to 44) versus 18 (10 to 32) mm/1st hour, P=0.005) and ca-CRP (0.7 (0.3 to 1.4) versus 0.4 (0.2 to 0.7) mg/dl, P=0.029).Using regression analysis, high ca-ESR (defined as ≥75th percentile: 37 mm/1st hour) was associated with a higher likelihood of being in the High PWV group (odds ratio (OR): 9.455 (1.939 to 46.093), P=0.005, adjusted for baseline clinical and cardiovascular risk factors; and 9.111 (1.875 to 44.275), P=0.006, adjusted for last visit parameters).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine & Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. shenjiayun@hotmail.com.

ABSTRACT

Introduction: The aim of this study was to examine whether the cumulative inflammatory burden is associated with an increase in arterial stiffness in a prospective cohort of psoriatic arthritis (PsA) patients.

Methods: In total, 72 PsA patients were followed for a median of 6.5 years. Cumulative inflammatory burden was represented by the cumulative averages of repeated measures of erythrocyte sedimentation rate (ca-ESR) and C-reactive protein (ca-CRP). Brachial-ankle pulse wave velocity (PWV) was measured at the last visit. We also included 47 healthy controls for PWV assessment.

Results: PWV was significantly higher in PsA patients compared with healthy controls after adjustment for age, gender and body weight (1466±29 cm/s versus 1323±38 cm/s, P=0.008). PsA patients were divided into two groups based on whether their PWV value is ≥1450 cm/s (High PWV group, N=38) or <1450 cm/s (Low PWV group, N=34). The High PWV group had a significantly higher ca-ESR (29 (19 to 44) versus 18 (10 to 32) mm/1st hour, P=0.005) and ca-CRP (0.7 (0.3 to 1.4) versus 0.4 (0.2 to 0.7) mg/dl, P=0.029). Using regression analysis, high ca-ESR (defined as ≥75th percentile: 37 mm/1st hour) was associated with a higher likelihood of being in the High PWV group (odds ratio (OR): 9.455 (1.939 to 46.093), P=0.005, adjusted for baseline clinical and cardiovascular risk factors; and 9.111 (1.875 to 44.275), P=0.006, adjusted for last visit parameters).

Conclusions: Cumulative inflammatory burden, as reflected by ca-ESR, was associated with increased arterial stiffness in PsA patients even after adjustment for cardiovascular risk factors, emphasizing the important role of chronic inflammation in accelerating the development of cardiovascular risks in PsA patients.

Show MeSH
Related in: MedlinePlus