Cardiovascular risk remains significant in psoriasis patients despite management of cardiometabolic comorbidities

Summary: Patients with psoriasis are known to have an increased prevalence of cardiovascular (CV) risk factors and be at increased risk for major adverse cardiovascular events (MACE). We designed a retrospective cohort study using a multicenter research network (TriNetX) to investigate whether disease-specific therapy of CV risk factors is associated with the incidence and risk of MACE in biologic-treated psoriasis patients aged 18 to 70, compared to patients in the general population. A series of analyses were conducted based on the presence of CV risk factors (dyslipidemia, hypertension, diabetes) and their treatment (statins, antihypertensives, antidiabetics). Patients were matched 1:1 by demographics, ASCVD score, and other potential confounders (SMD <0.2). Compared to the general population, psoriasis patients demonstrated an increased incidence and risk for MACE (116 vs 64, HR 3.4 95% CI 2.5-4.7), independent of traditional risk factors. Stratification by comorbidity revealed increased incidence and risk for MACE among psoriasis patients with dyslipidemia (1,407 vs 293, HR 5.6 95% CI 4.9-6.4), hypertension (1,387 vs 200, HR 8.00 95% CI 6.9-9.3), and diabetes (676 vs 106, HR 7.4 95% CI 6.0-9.1), compared to controls in the general population. Comparing biologic-treated psoriasis patients stratified by comorbidity and pharmacologic management, those with dyslipidemia had a higher incidence and risk for MACE despite receiving a statin (153 vs 49, HR 3.1 95% CI 2.2-4.3); similarly, those with hypertension had a higher incidence and risk for MACE despite receiving antihypertensives (85 vs 31, HR 2.6 95% CI 1.7-3.9), while psoriasis patients receiving management for diabetes did not have significant differences in the incidence or risk for MACE compared to those not receiving antidiabetics (60 vs 57, HR 0.9 95% CI 0.7-1.4). Despite pharmacologic management of both psoriasis and CV risk factors, significant residual cardiovascular risk remains in patients with psoriasis. Ana Ormaza¹, Chunghwan Ro¹, Nehal Mehta², Clinton W. Enos¹ 1. Dermatology, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States. 2. The George Washington University, Washington, DC, United States. Clinical Research: Epidemiology and Observational Research