Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, FL, USA.
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Atherosclerosis. 2014 Jan;232(1):72-8. doi: 10.1016/j.atherosclerosis.2013.10.023. Epub 2013 Nov 1.
Psoriasis patients have a high prevalence of cardiovascular events and are thought to have a relative risk increase of 25% as compared to the general population. However, a causal relationship between psoriasis and cardiovascular disease has not been established. We sought to perform a systematic review of existing data regarding the presence of endothelial dysfunction and subclinical atherosclerosis in patients with plaque psoriasis.
A systematic literature search was performed, using Medline database and Ovid SP for relevant literature up to November 2012. Twelve studies met inclusion criteria from an initial search result of 529 articles.
Among the twelve studies meeting inclusion criteria, two (17%) reported increased mean coronary artery calcification (CAC) in psoriatic patients. Six studies (50%) showed carotid intima-media thickness [CIMT] increase in psoriasis. Five studies (42%) examined flow mediated dilation [FMD], of which three showed decreased FMD in psoriasis patients. One study (8%) each demonstrated a decreased coronary flow reserve and increased arterial stiffness as assessed by pulse wave velocity.
Patients with psoriasis have an increased burden of subclinical atherosclerosis and endothelial dysfunction. Patients with greater severity and/or disease duration should be targeted for primary screening for cardiovascular disease risk reduction.
银屑病患者心血管事件的发生率较高，与普通人群相比，其相对风险增加了 25%。然而，银屑病与心血管疾病之间的因果关系尚未确立。我们旨在对现有的关于斑块状银屑病患者内皮功能障碍和亚临床动脉粥样硬化的存在的相关数据进行系统回顾。
使用 Medline 数据库和 Ovid SP 对截至 2012 年 11 月的相关文献进行了系统的文献检索。从最初的 529 篇文章中，有 12 项研究符合纳入标准。
在符合纳入标准的 12 项研究中，有两项（17%）报告银屑病患者的平均冠状动脉钙化（CAC）增加。六项研究（50%）显示银屑病患者颈动脉内膜中层厚度（CIMT）增加。五项研究（42%）检查了血流介导的扩张（FMD），其中三项显示银屑病患者的 FMD 降低。一项研究（8%）分别显示冠状动脉血流储备减少和脉搏波速度评估的动脉僵硬度增加。
银屑病患者亚临床动脉粥样硬化和内皮功能障碍的负担增加。应针对病情严重程度和/或疾病持续时间较高的患者进行心血管疾病风险降低的初步筛查。
