Biomarkers Associated With Cardiovascular Outcomes in Psoriatic Patients

Psoriasis and psoriatic arthritis (PsA), collectively known as psoriatic disease (PsD), are characterized by excess cardiovascular (CV) morbidity and mortality compared to the general population.

Novel laboratory and imaging biomarkers improve CV risk prediction in the general population, and it has been suggested that they could be combined with conventional scoring systems to optimize CV risk stratification.

A group of Medical Scientists working with the Women’s College Hospital (Toronto, ON, Canada) included in a study, a cohort comprised of participants with a diagnosis of psoriasis without arthritis (PsC) followed since 2006, and psoriatic arthritis (PsA) that have been followed prospectively since 1978 as part of a larger study to investigate disease-related outcomes. Among PsA patients, 98% meet the Classification of Psoriatic Arthritis (CASPAR) criteria. PsC patients are enrolled based on a diagnosis of arthritis conformed by a dermatologist and a rheumatologist.

Annual serum samples have been collected and stored in a biobank since 2002, thus patients entered this study at the date they provided their first serum sample. NT-proBNP (Cobas, Roche Diagnostics, Indianapolis, IN, USA) and high-sensitivity cTnI (ARCHITECT STAT, Abbott Laboratories, Abbott Diagnostics, Abbott Park, IL, USA) were measured in serum samples on automated clinically validated immunoassay analyzers using the manufacturers’ calibrators and quality controls. The limit of detection was 5 pg/mL for NT-proBNP and 1.1 pg/mL for cTnI.

The association between cardiac biomarkers and carotid atherosclerosis was assessed by multivariable regression after adjusting for CV risk factors. In univariate analyses, cTnI (β coefficient, 0.52; 95% confidence interval (CI), 0.3-0.74) and NT-proBNP (β coefficient, 0.24; 95% CI, 0.1-0.39) were associated with carotid total plaque area (TPA). After adjusting for CV risk factors, the association remained statistically significant for cTnI (adjusted β coefficient, 0.21; 95% CI, 0-0.41), but not NT-proBNP. Among all the 1,000 patients in the study who were assessed for CV risk prediction, 64 patients had incident CV events. When comparing a base model with the Framingham Risk Score alone versus expanded models that included the Framingham Risk Score plus cardiac biomarkers, there was no improvement in predictive performance.

The authors concluded that in patients with psoriatic disease (PsD), cTnI may reflect the burden of atherosclerosis, independent of traditional CV risk factors. cTnI and NT-proBNP are associated with incident CV events independent of the Framingham Risk Score (FRS), however, further study of their role in CV risk stratification is warranted. The study was published on march 8, 2022 in the journal Arthritis & Rheumatology.

Related Links:
Women’s College Hospital 
Roche Diagnostics 
Abbott Diagnostics