Merzel Šabović Eva Klara, Kraner Šumenjak Tadeja, Božič Mijovski Mojca, Janić Miodrag
Department of Dermatovenerology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Front Med (Lausanne). 2025 Aug 21;12:1611827. doi: 10.3389/fmed.2025.1611827. eCollection 2025.
Psoriasis is associated with increased cardiovascular risk, possibly mediated by inflammation-induced hemostatic dysregulation and hypercoagulability. However, these changes are often difficult to detect with conventional markers.
To assess hypercoagulability in patients with psoriasis using the Overall Hemostatic Potential (OHP) test, a global integrative test for coagulation and fibrinolysis.
We studied 80 psoriasis patients (54 men, 26 women, aged 30-45 years) receiving effective topical or systemic treatments (methotrexate, adalimumab, secukinumab or guselkumab) and compared them with 20 healthy controls. We measured OHP, its components - overall coagulation potential (OCP) and overall fibrinolytic potential (OFP) and selected hemostatic markers (platelet count, mean platelet volume, platelet-to-lymphocyte ratio, P-selectin, D-dimer and fibrinogen).
Psoriasis patients had significantly higher OHP levels, primarily due to decreased OFP, while OCP levels were comparable to the control group - indicating a hypercoagulable state due to impaired fibrinolysis. Other conventional hemostatic markers showed no significant differences. OHP and OFP correlated with residual inflammatory activity, BMI, waist circumference, visceral adiposity and fibrinogen levels, suggesting a relationship between subclinical inflammation, metabolic parameters and hemostatic imbalance.
The OHP test reveals a hypercoagulable state in psoriasis patients even in the absence of abnormal standard coagulation markers. OHP could be a practical and sensitive tool to stratify cardiovascular risk in psoriasis, especially in patients with concomitant metabolic disease or persistent inflammation.
银屑病与心血管风险增加相关，可能是由炎症诱导的止血失调和高凝状态介导的。然而，这些变化通常难以用传统标志物检测到。
使用整体止血潜能（OHP）试验评估银屑病患者的高凝状态，该试验是一种用于凝血和纤维蛋白溶解的综合检测。
我们研究了80例接受有效局部或全身治疗（甲氨蝶呤、阿达木单抗、司库奇尤单抗或古塞库单抗）的银屑病患者（54名男性，26名女性，年龄30 - 45岁），并将他们与20名健康对照者进行比较。我们测量了OHP、其组成部分——整体凝血潜能（OCP）和整体纤维蛋白溶解潜能（OFP）以及选定的止血标志物（血小板计数、平均血小板体积、血小板与淋巴细胞比值、P-选择素、D-二聚体和纤维蛋白原）。
银屑病患者的OHP水平显著更高，主要是由于OFP降低，而OCP水平与对照组相当——表明由于纤维蛋白溶解受损而处于高凝状态。其他传统止血标志物无显著差异。OHP和OFP与残余炎症活动、体重指数、腰围、内脏脂肪以及纤维蛋白原水平相关，提示亚临床炎症、代谢参数和止血失衡之间存在关联。
即使在没有异常标准凝血标志物的情况下，OHP试验也能揭示银屑病患者的高凝状态。OHP可能是一种实用且敏感的工具，用于对银屑病患者的心血管风险进行分层，尤其是对于伴有代谢疾病或持续性炎症的患者。
