Zhao Lin, Sun Lin, Yang Kunqi, Li Zuozhi, Wang Yan, Wang Tianjie, Wang Man, Zeng Yan, Zhou Xianliang, Yang Weixian
Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Apr 10;16:1003-1012. doi: 10.2147/DMSO.S402618. eCollection 2023.
Psoriasis is associated with an increased prevalence of cardiovascular risk factors, including metabolic syndrome (MetS). To date, it is unclear whether MetS causes differences in cardiovascular outcomes in psoriatic patients with coronary artery disease.
We conducted a retrospective cohort study to determine the effects of MetS in psoriatic patients with coronary artery disease. Comparisons were made between patients with and without MetS. Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between variables.
Of the 307 psoriatic patients with coronary artery disease, 94 met criteria (30.6%) for MetS. Individuals with MetS were more likely to be female (p <0.001). Levels of platelet counts and high-sensitivity C-reactive protein were higher in the MetS group (p = 0.038 and 0.005, respectively). After a mean follow-up of 35.32 months, major adverse cardiovascular events (MACEs) and non-fatal myocardial infarction were more likely in the MetS than the non-MetS group (33.3% vs 20.6%, p = 0.02; 26.4% vs 15.7%, p = 0.032, respectively). Kaplan-Meier estimates showed the same trend. Cox regression analysis showed that MetS (hazard ratio 1.738; 95% confidence interval 1.045-2.891; p = 0.033) and left ventricular ejection fraction (hazard ratio 0.968; 95% confidence interval 0.945-0.991; p = 0.006) were associated with an increased risk of MACEs.
In psoriatic patients with coronary artery disease, MetS independently predicted MACEs. In addition, left ventricular ejection fraction was negatively associated with an increased risk of MACEs. To reduce the cardiovascular disease risk, it is necessary to increase awareness of MetS in psoriatic patients with coronary artery disease.
银屑病与心血管危险因素（包括代谢综合征（MetS））的患病率增加有关。迄今为止，尚不清楚MetS是否会导致银屑病合并冠状动脉疾病患者的心血管结局出现差异。
我们进行了一项回顾性队列研究，以确定MetS对银屑病合并冠状动脉疾病患者的影响。对有和没有MetS的患者进行了比较。采用Cox回归分析和Kaplan-Meier生存分析来评估变量之间的关联。
在307例银屑病合并冠状动脉疾病患者中，94例符合MetS标准（30.6%）。患有MetS的个体更可能为女性（p<0.001）。MetS组的血小板计数和高敏C反应蛋白水平更高（分别为p=0.038和0.005）。平均随访35.32个月后，MetS组发生主要不良心血管事件（MACE）和非致命性心肌梗死的可能性高于非MetS组（分别为33.3%对20.6%，p=0.02；26.4%对15.7%，p=0.032）。Kaplan-Meier估计显示出相同趋势。Cox回归分析表明，MetS（风险比1.738；95%置信区间1.045-2.891；p=0.033）和左心室射血分数（风险比0.968；95%置信区间0.945-0.991；p=0.006）与MACE风险增加相关。
在银屑病合并冠状动脉疾病患者中，MetS独立预测MACE。此外，左心室射血分数与MACE风险增加呈负相关。为降低心血管疾病风险，有必要提高银屑病合并冠状动脉疾病患者对MetS的认识。
