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Piaserico S, Papadavid E, Cecere A, Orlando G, Theodoropoulos K, Katsimbri P, Makavos G, Rafouli-Stergiou P, Iliceto S, Alaibac M, Tona F, Ikonomidis I. Coronary Microvascular Dysfunction in Asymptomatic Patients with Severe Psoriasis. J Invest Dermatol 2023; 143:1929-1936.e2. [PMID: 37739764 DOI: 10.1016/j.jid.2023.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/31/2023] [Accepted: 02/22/2023] [Indexed: 09/24/2023]
Abstract
Severe psoriasis is associated with an increased cardiovascular risk, which may be independent of the traditional risk factors. Coronary microvascular dysfunction (CMD) has been shown to predict a poor cardiovascular prognosis in the general population and in patients with psoriasis. In this study, we assessed the prevalence and predictors of CMD in a large cohort of patients with psoriasis without clinical cardiovascular disease. A total of 503 patients with psoriasis were enrolled and underwent transthoracic Doppler echocardiography to evaluate coronary microcirculation. Of these, 55 patients were excluded from the analyses because of missing data. Of the 448 patients in this study, 31.5% showed CMD. Higher PASI, longer disease duration, the presence of psoriatic arthritis, and hypertension were independently associated with CMD. An increase of 1 point of PASI and 1 year of psoriasis duration were associated with a 5.8% and 4.6% increased risk of CMD, respectively. In our study, CMD was associated with the severity and duration of psoriasis. This supports the role of systemic inflammation in CMD and suggests that the coronary microcirculation may represent an extracutaneous site involved in the immune-mediated injury of psoriasis. We should diagnose and actively search for CMD in patients with severe psoriasis.
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Affiliation(s)
- Stefano Piaserico
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy.
| | - Evangelia Papadavid
- Department of Dermatology and Venereology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Annagrazia Cecere
- Division of Cardiology, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Gloria Orlando
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Konstantrinos Theodoropoulos
- Department of Dermatology and Venereology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Pelagia Katsimbri
- Department of Dermatology and Venereology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Makavos
- 2(nd) Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Penelope Rafouli-Stergiou
- 2(nd) Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sabino Iliceto
- Division of Cardiology, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Mauro Alaibac
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Francesco Tona
- Division of Cardiology, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Ignatios Ikonomidis
- 2(nd) Cardiology Department, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Bardazzi F, Odorici G, Ferrara F, Magnano M, Balestri R, Patrizi A. Sex and the PASI: patients affected by a mild form of psoriasis are more predisposed to have a more severe form of erectile dysfunction. J Eur Acad Dermatol Venereol 2016; 30:1342-8. [DOI: 10.1111/jdv.13625] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 01/07/2016] [Indexed: 12/21/2022]
Affiliation(s)
- F. Bardazzi
- Dermatology Unit; Department of Specialistic, Diagnostic and Experimental Medicine; S. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - G. Odorici
- Dermatology Unit; Department of Specialistic, Diagnostic and Experimental Medicine; S. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - F. Ferrara
- Dermatology Unit; Department of Specialistic, Diagnostic and Experimental Medicine; S. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - M. Magnano
- Dermatology Unit; Department of Specialistic, Diagnostic and Experimental Medicine; S. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - R. Balestri
- Dermatology Unit; Department of Specialistic, Diagnostic and Experimental Medicine; S. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
| | - A. Patrizi
- Dermatology Unit; Department of Specialistic, Diagnostic and Experimental Medicine; S. Orsola-Malpighi Hospital; University of Bologna; Bologna Italy
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Egeberg A. Does systemic antipsoriatic therapy affect the cardiovascular risk? Br J Dermatol 2015; 173:1362-3. [PMID: 26708541 DOI: 10.1111/bjd.14149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Egeberg
- Departments of Cardiology and Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark.
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