Coronary Artery Disease Assessment in Psoriasis Patients Well‐Controlled Under Systemic Anti‐Inflammatory Treatments—A Real‐World Observational Study From a Single Center

Atherosclerosis is now considered to reflect systemic inflammation involving the elevation of multiple proinflammatory cytokines, sharing common underlying pathophysiological mechanisms with psoriasis. There has been increasing interest in whether anti-inflammatory treatment of psoriasis can prevent or halt the progression of atherosclerosis. Here, we conducted a cross-sectional observational clinical study in psoriasis patients with at least one traditional cardiovascular risk factor, such as diabetes, hypertension, or dyslipidemia, and who were being treated with systemic anti-inflammatory drugs. To assess CAD risk, we performed coronary computed tomography angiography (CCTA). We assessed 27 psoriasis patients (14 males/13 females), whose median PASI score was 0 [range, 0-2.3] at the time of CCTA. They had sustained well-controlled psoriasis for a median of 44 months [range, 1-144]. Coronary plaques of varying degrees were detected in 20 patients (74%) by CCTA. Four patients were diagnosed with silent myocardial ischemia (SMI) by invasive coronary angiography (CAG), revealing severe coronary stenosis in major arteries. The severity of coronary plaque burden was significantly associated with male sex, hypertension, and carotid ultrasound abnormalities. Furthermore, notably, we detected a significant positive correlation between the duration of biologic treatment and calcified plaque burden among patients treated with biologic agents for over 6 months. Our study highlights the importance of tight disease control and screening for CAD even in well-controlled psoriasis patients. Further accumulation of studies may lead to better management of CAD risks in this population.