PhD Scientific Days 2023

Budapest, 22-23 June 2023

Clinical Medicine - Posters J

The Role of Dermatologists in the Early Recognition of Cardiovascular Disease in Patients with Moderate-to-Severe Psoriasis

Bernadett Hon-Balla1, Noémi Ágnes Galajda1, Anna Éva Piros1, Andrea Lukács1, Klára Szalai1, Mária Veronika Kolonics1, Bálint Szilveszter2, Borbála Vattay2, Pál Maurovich-Horvat3, Béla Merkely2, Péter Holló1,

1 Department of Dermatology, Venereology and Dermato-oncology, Semmelweis University, Budapest
2 Heart and Vascular Centre, Semmelweis University, Budapest
3 Medical Imaging Centre, Semmelweis University, Budapest

Text of the abstract

Introduction: Psoriasis is a chronic, relapsing autoinflammatory disease and it is characterised by the classic triad of erythema, induration, and desquamation. The systemic inflammation responsible for the persistence of the symptoms has a significant impact on the cardiovascular system and psoriasis is considered to be an independent risk factor for the development of cardiovascular disease, including atherosclerosis.

Aims: To assess the cardiac status and the effect of IL-23 inhibitor therapy on the cardiovascular system in patients with moderate-to-severe psoriasis over a one-year prospective study.

Methods: Patients with moderate-to-severe (Psoriasis Area and Severity Index > 10) psoriasis without cardiac symptoms undergoing IL-23 inhibitor therapy at the Department of Dermatology, Dermatology and Dermato-oncology, Semmelweis University, were consecutively included in the study. Patients underwent ultrasound examination to assess the intima-media thickness of the carotid, brachial and femoral arteries. Cardiac computed tomography (CT) was performed, and the Coronary Artery Calcification Score (CACS) was calculated. Laboratory parameters including lipid panel and CRP were assessed.

Results: Currently, 8 patients have been enrolled, 7 male and one female. Guselkumab was given to 6 patients and 2 received risankizumab. Comorbidities included psoriatic arthritis (n=7), hypertension (n=3), type II diabetes mellitus (n=1), depression (n=1), hypothyroidism (n=1), hyperlipidaemia (n=1), and fatty liver disease (n=1). Six patients were smokers. The average BMI was 30.64 and the mean PASI was 18.09. Ultrasound was performed in 4 patients and only one patient had calcified plaques. Out of the 8 patients, 6 were categorised into the high-risk group (CACS>0), with the highest calcium score being 1052.

Conclusion: Dermatologists have a significant role in screening high cardiovascular-risk patients. In addition to ECG and echocardiography recommended by international guidelines, further examinations are needed, such as ultrasound and cardiac CT in patients with moderate-to-severe psoriasis.

Funding: None.