Atherogenic Lipoprotein Burden, Metabolic Stress and Immune Activation Associated with Coronary Atherosclerosis in Patients with Psoriasis.

Remnant cholesterol emerged as a strong independent predictor of coronary stenosis in patients with psoriasis.

• Patients with psoriasis (n = 104) without known coronary artery disease underwent coronary computed tomography angiography (CCTA) to detect subclinical coronary atherosclerosis.
• Remnant cholesterol was identified as an independent predictor of coronary stenosis in multivariate logistic regression models.
• Patients with coronary atherosclerosis exhibited a more adverse lipid profile overall compared to those without coronary atherosclerosis.
• Lipid fractions including remnant cholesterol were analyzed alongside clinical data and metabolic parameters.

Elevated IgA levels were associated with the presence of coronary atherosclerosis in psoriasis patients, suggesting a role of immune activation beyond general systemic inflammation.

• Immunoglobulin A (IgA) was measured as an immunological marker in the study population of 104 psoriasis patients.
• Elevated IgA levels were associated with CT-confirmed coronary stenosis in univariate and/or multivariate logistic regression analyses.
• The authors note this finding suggests a potential role of immune activation that 'extends beyond general systemic inflammation.'
• IgA was included as part of a broader immuno-metabolic risk profile analysis.

Longer duration of psoriasis correlated with the presence of coronary atherosclerosis, highlighting the importance of cumulative inflammatory burden.

• Disease duration was analyzed as a clinical variable in 104 psoriasis patients without known coronary artery disease.
• Longer psoriasis duration was associated with CT-confirmed coronary stenosis detected by CCTA.
• The authors describe this as reflecting 'the importance of cumulative inflammatory burden' in the pathogenesis of coronary atherosclerosis.
• The finding was assessed using univariate and multivariate logistic regression models.

Patients with psoriasis and coronary atherosclerosis exhibited a more adverse metabolic and lipid profile compared to those without coronary atherosclerosis.

• The study enrolled 104 psoriasis patients without known coronary artery disease who underwent CCTA.
• Metabolic parameters and indices, lipid fractions including remnant cholesterol, and immunological markers were compared between patients with and without CT-confirmed coronary stenosis.
• The adverse metabolic profile in those with coronary atherosclerosis encompassed multiple atherogenic lipoprotein fractions.
• These differences were assessed using univariate and multivariate logistic regression models.

Subclinical coronary atherosclerosis was detectable by CCTA in a population of psoriasis patients without known coronary artery disease.

• All 104 study participants had psoriasis but no known coronary artery disease prior to enrollment.
• Coronary computed tomography angiography (CCTA) was used to detect subclinical coronary atherosclerosis and confirm coronary stenosis.
• The study design allowed assessment of associations between clinical, metabolic, and immunological variables and CT-confirmed coronary stenosis.
• The authors conclude that cardiovascular risk assessment in psoriasis patients should extend 'beyond the evaluation of traditional cardiovascular risk factors alone.'