natriuretic-peptide--brain and Arthritis--Psoriatic

In patients with psoriatic disease (PsD), we determined whether cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were associated with carotid plaque burden and the development of cardiovascular events independent of the Framingham Risk Score (FRS).. Among 1,000 patients with PsD, carotid total plaque area (TPA) was measured in 358 participants at baseline. Cardiac troponin I and NT-proBNP were measured using automated clinical assays. The association between cardiac biomarkers and carotid atherosclerosis was assessed by multivariable regression after adjusting for cardiovascular risk factors. Improvement in the prediction of cardiovascular events beyond the FRS was tested using measures of risk discrimination and reclassification.. In univariate analyses, cTnI (β coefficient 0.52 [95% confidence interval (95% CI) 0.3, 0.74], P < 0.001) and NT-proBNP (β coefficient 0.24 [95% CI 0.1, 0.39], P < 0.001) were associated with TPA. After adjusting for cardiovascular risk factors, the association remained statistically significant for cTnI (adjusted β coefficient 0.21 [95% CI 0, 0.41], P = 0.047) but not for NT-proBNP (P = 0.21). Among the 1,000 patients with PsD assessed for cardiovascular risk prediction, 64 patients had incident cardiovascular events. When comparing a base model (with the FRS alone) to expanded models (with the FRS plus cardiac biomarkers), there was no improvement in predictive performance.. In patients with PsD, cTnI may reflect the burden of atherosclerosis, independent of traditional cardiovascular risk factors. Cardiac troponin I and NT-proBNP are associated with incident cardiovascular events independent of the FRS, but further study of their role in cardiovascular risk stratification is warranted.

Topics: Arthritis, Psoriatic; Biomarkers; Carotid Artery Diseases; Cohort Studies; Humans; Longitudinal Studies; Natriuretic Peptide, Brain; Peptide Fragments; Plaque, Atherosclerotic; Prognosis; Psoriasis; Risk Assessment; Risk Factors; Troponin I

Past studies have reported associations between psoriasis, metabolic syndrome, and atherosclerotic cardiovascular disease. According to studies, N-terminal pro B-type natriuretic peptide (NT-proBNP) is a useful screening test for cardiac disease. We examined the serum NT-proBNP level in patients with psoriasis and compared them with nonpsoriatic healthy control subjects. Sixty-one patients with psoriasis were enrolled, along with 61 age, sex, and body mass index (BMI) matched control subjects. In both groups, NT-proBNP serum levels and lipid profile parameters were investigated. Means and 95% confidence intervals (CIs) were reported. The median serum concentration of NT-proBNP was higher in psoriatic patients than the control group (26.67 [interquartile range (IQR): 15.15-43.03 and range: 5-250] vs. 17.45 [IQR: 12.35-20.80 and range: 5-45.09, p < 0.0001). NT-proBNP serum level in psoriatic arthritis patients (11%; 55.6 ± 25.7 pg/mL, 95% CI: 31.9-79.4 pg/mL) was higher than psoriasis patients without arthritis (35.8 ± 40.6 pg/mL, CI: 24.7-46.9, p < 0.001). NT-proBNP levels were also positively correlated with BMI, lipid profile, and disease duration. NT-proBNP is elevated in patients with psoriasis, consistent with the high risk of cardiovascular disease associated with psoriasis.

Topics: Adult; Arthritis, Psoriatic; Body Mass Index; Cardiovascular Diseases; Case-Control Studies; Female; Humans; Lipids; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Psoriasis; Risk Factors; Time Factors