Eder Lihi, Gladman Dafna D
Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Ontario, Canada.
Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst St. 1E-410B, Toronto, Ontario, Canada M5T 2S8.
Ther Adv Musculoskelet Dis. 2015 Oct;7(5):187-95. doi: 10.1177/1759720X15591801.
It is widely accepted that atherosclerosis is caused by chronic low-grade inflammation that results from an interaction between immune mechanisms and metabolic abnormalities within the vessel wall. Population-based studies have found an increased cardiovascular risk in patients with psoriasis and psoriatic arthritis (PsA). This risk is higher in patients with severe disease phenotypes, such as those with severe psoriasis and with musculoskeletal inflammation. Higher levels of inflammatory biomarkers also predict the development of clinical cardiovascular events in these patients. The effect of medications used for PsA on cardiovascular risk is limited to observational studies. Antitumor necrosis factor agents and methotrexate have been associated with reduced cardiovascular risk. These data highlight the importance of screening for cardiovascular risk factors in these patients.
普遍认为，动脉粥样硬化是由血管壁内免疫机制与代谢异常相互作用导致的慢性低度炎症引起的。基于人群的研究发现，银屑病和银屑病关节炎（PsA）患者的心血管风险增加。在患有严重疾病表型的患者中，如重度银屑病和肌肉骨骼炎症患者，这种风险更高。较高水平的炎症生物标志物也可预测这些患者临床心血管事件的发生。用于治疗PsA的药物对心血管风险的影响仅限于观察性研究。抗肿瘤坏死因子药物和甲氨蝶呤与降低心血管风险有关。这些数据凸显了在这些患者中筛查心血管危险因素的重要性。
