Prevalence and Risk Factors of Atherosclerosis in Patients with Psoriatic Arthritis

Oded Kimhi, Dan Caspi, Natan M. Bornstein, Nitsan Maharshak, Alexander Gur, Yaron Arbel, Doron Comaneshter, Daphna Paran, Irena Wigler, David Levartovsky, Shlomo Berliner, Ori Elkayam*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

192 Scopus citations


Objectives: To evaluate the extent of subclinical atherosclerosis by measuring the intima-media wall thickness (IMT) of the common carotid artery in patients with psoriatic arthritis (PsA) and to identify vascular risk factors associated with PsA. Methods: Forty-seven patients with PsA were compared with 100 allegedly healthy subjects. Carotid duplex scanning was used to measure common carotid artery IMT. Traditional risk factors, such as gender, age, body mass index (BMI), hypertension, smoking, and lipids were checked. Assessment of PsA activity included clinical patterns of involvement, degree of severity, duration of morning stiffness, number of tender and swollen joints, degree of pain and fatigue, the Bath Ankylosing Spondylitis Disease Activity Index, the Psoriasis Area and Severity Index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fibrinogen. Results: The average IMT (mean ± standard deviation) for PsA patients was significantly higher compared with controls (0.76 ± 0.11 versus 0.64 ± 0.27, respectively, P < 0.00001) for the whole group and after adjustment for age, gender, BMI, hypertension, and hyperlipidemia. The PsA subjects had significantly higher levels of hypertension, hyperlipidemia, ESR, CRP, and fibrinogen, and their average IMT significantly correlated with age, BMI, duration of skin and joint disease, spine involvement, ESR, and fibrinogen. IMT did not correlate with the presence of oligo- or polyarthritis but was increased in patients with clinical spinal involvement. IMT was not associated with the degree of severity or the use of different therapies for PsA, including methotrexate or tumor necrosis factor-α-blocking agents. Conclusions: PsA patients exhibited greater IMT than healthy controls. Increased IMT independently correlated with parameters of disease activity and conventional risk factors of atherosclerosis.

Original languageEnglish
Pages (from-to)203-209
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Issue number4
StatePublished - Feb 2007


  • atherosclerosis
  • intima-media wall thickness
  • psoriatic arthritis


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