Higher Disease Activity in Psoriatic Arthritis (DAPSA) scores, as well as the presence of carotid plaque, may independently predict cardiovascular disease (CVD) events among patients with psoriatic arthritis (PsA), according to a new study.
To reach this conclusion, the researchers conducted a longitudinal study of 189 patients with PsA to determine whether DAPSA scores—which reflect the inflammatory component of psoriatic arthritis—could predict cardiovascular (CV) events independent of traditional CV risk factors and subclinical carotid atherosclerosis.
At baseline, when the average patient age was 49 years, researchers calculated 4 CVD risk scores as well as DAPSA scores for each patient. In a subgroup of 154 patients, high-resolution ultrasonography scans determined the presence of carotid plaque as well as carotid intima-media thickness.
Over a median 9.9 years of follow-up, 14.3% of patients had experienced a CV event. The researchers found a significant association between higher DAPSA scores and increased risk of CV events; the researchers reported a hazard ratio of 1.04, 95% CI (1.01 to 1.08). The association remained significant in multivariable models that adjusted for all 4 CV risk scores, according to the researchers.
Among the 154 patients who had undergone carotid ultrasonography assessment, 14.9% had a CV event.
“[Carotid plaque] was associated with increased risk of developing CV events after adjusting for 3 CV risk scores and DAPSA with [hazard ratios] ranging from 2.35 to 3.42,” the researchers wrote.
Lam SHM, Cheng IT, Li EK, et al. DAPSA, carotid plaque and cardiovascular events in psoriatic arthritis: a longitudinal study. Anne Rheum Dis. 2020;79(10):1320-1326. doi:10.1136/annrheumdis-2020-217595