Introduction: The relationship between the phenotype and treatment of psoriatic arthritis (PsA) and the increased prevalence of cardiovascular comorbidities is not well studied.
Objective: To assess the prevalence of cardiovascular comorbidities in relation to the clinical phenotype and treatment of PsA.
Methods: This was a cross-sectional, real-life study. Demographic and clinical data were recorded in patients with PsA. The relationships between clinical phenotypes (axial, oligoarthritis, polyarthritis, and mixed), cardiovascular risk factors, comorbidities, and treatment were analyzed.
Results: Among the 267 patients studied, no differences were found between the prevalence of cardiovascular risk factors or comorbidities in relation to the clinical phenotypes of PsA. However, patients with oligoarthritis had hypertension more frequently (38.8% vs 22.0%, p=0.011). Patients with any cardiovascular disease were more often under current treatment with glucocorticosteroids (17.9% vs 4.8%, p=0.001) as well as exposed to them in the past (22.6% vs 13.%, p=0.02). 83.3% of patients with ongoing non-steroidal anti-inflammatory drugs (NSAIDs) had heart failure compared to patients without heart failure among whom 35.3% were currently taking NSAIDs (p=0.03). 15.4% of patients had diagnosed dyslipidemia but LDL level greater than 3.0 mmol/l was detected in 36.6% of patients. Multivariable logistic regression analysis identified the current use of glucocorticosteroids and oligoarthritis as predictive factors for cardiovascular comorbidities.
Conclusion: The use of glucocorticoids and NSAIDs is associated with an increased prevalence of cardiovascular comorbidities in patients with PsA and should be avoided. Oligoarthritis and the current use of glucocorticosteroids are predictors of cardiovascular comorbidities. Hyperlipidemia remains underrecognized in patients with PsA within a real-world context.
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