Ischemic cardiovascular involvement in psoriasis: A systematic review

Susanna Mosca, Paola Gargiulo, Nicola Balato, Luisa Di Costanzo, Antonio Parente, Stefania Paolillo, Fabio Ayala, Bruno Trimarco, Filippo Crea, Pasquale Perrone-Filardi

Research output: Contribution to journalArticle

Abstract

Epidemiologic studies demonstrate that psoriasis is associated with shorter life expectancy, most frequently attributable to cardiovascular (CV) events. Although increased prevalence and incidence of CV risk factors for atherosclerosis have been reported in psoriatic patients, psoriasis likely plays an independent role in the increased cardiovascular risk, presumably linked to the chronic systemic inflammatory state. Consistently, preliminary investigations suggest that anti-inflammatory therapies may improve early subclinical vascular alterations and reduce cardiovascular morbidity and mortality. This review will focus on ischemic CV involvement in psoriatic patients, summarizing the prevalence and incidence of CV risk factors and CV events, as well as evidence on mechanisms of premature atherosclerosis and on effects of systemic anti-inflammatory therapies on CV risk profile. We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and evaluated the quality of studies comparing drug treatments using Detsky score. Our review documented that psoriatic patients are at increased CV risk, related to raised prevalence and incidence of CV risk factor and to inflammatory status. However, available literature lacks of studies that establish appropriate targets for CV risk factors and assess the clinical value of screening for subclinical organ damage and the impact of disease-modifying therapies on CV risk profile in psoriatic patients. Awareness of raised CV risk in psoriatic patients should foster further research aimed at elucidating these aspects.

Original languageEnglish
Pages (from-to)191-199
Number of pages9
JournalInternational Journal of Cardiology
Volume178
DOIs
Publication statusPublished - Jan 15 2015

Keywords

  • Atherosclerosis
  • Cardiovascular risk
  • Coronary artery disease
  • Inflammation
  • Psoriasis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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  • Cite this

    Mosca, S., Gargiulo, P., Balato, N., Di Costanzo, L., Parente, A., Paolillo, S., Ayala, F., Trimarco, B., Crea, F., & Perrone-Filardi, P. (2015). Ischemic cardiovascular involvement in psoriasis: A systematic review. International Journal of Cardiology, 178, 191-199. https://doi.org/10.1016/j.ijcard.2014.10.092