Association of cardiac biomarkers with cardiovascular outcomes in patients with psoriatic arthritis and psoriasis: a longitudinal cohort study

Colaço, K. et al. (2022) Association of cardiac biomarkers with cardiovascular outcomes in patients with psoriatic arthritis and psoriasis: a longitudinal cohort study. Arthritis and Rheumatology, 74(7), pp. 1184-1192. (doi: 10.1002/art.42079) (PMID:35261189)

Abstract

Objective: In patients with psoriatic disease (PsD), we determined whether cardiac troponin I (cTnI) and N-terminal pro-brain-type natriuretic peptide (NT-proBNP) were associated with carotid plaque burden and the development of cardiovascular (CV) events independent of the Framingham Risk Score (FRS). Methods: Among 1,000 patients with PsD, carotid total plaque area (TPA) was measured in 358 participants at baseline. cTnI 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 CV risk factors. Improvement in the prediction of CV events beyond the FRS was tested using measures of risk discrimination and reclassification. Results: In univariate analyses, cTnI (β coefficient 0.52 [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 CV risk factors, the association remained statistically significant for cTnI (adjusted β coefficient 0.21 [95% CI 0, 0.41], p=0.047), but not NT-proBNP (p=0.21). Among 1,000 patients with PsD assessed for CV risk prediction, 64 patients had incident CV 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. Conclusion: In patients with PsD, cTnI may reflect the burden of atherosclerosis, independent of traditional CV risk factors. cTnI and NT-proBNP are associated with incident CV events independent of the FRS, however, further study of their role in CV risk stratification is warranted.

• Item Type: Articles
• Additional Information: Keith Colaco is supported by the Enid Walker Estate, Women’s College Research Institute, Arthritis Society (TGP-19-0446), National Psoriasis Foundation (Early Career Grant) and the Edward Dunlop Foundation. Lihi Eder is supported by a Young Investigator Award from the Arthritis Society (YIA-16-394) and an Early Researcher Award from the Ontario Ministry of Science and Innovation. Vinod Chandran is supported by a Pfizer Chair Research Award, Rheumatology, University of Toronto, Canada. The study was supported in part by a Discovery Grant from the National Psoriasis Foundation and an operating grant from the Arthritis Society (YIO-16-394). The Psoriatic Disease Program has been supported by a grant from the Krembil Foundation.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McInnes, Professor Iain and Sattar, Professor Naveed and Welsh, Professor Paul
• Authors: Colaço, K., Lee, K.‐A., Akhtari, S., Winer, R., Welsh, P., Sattar, N., McInnes, I. B., Chandran, V., Harvey, P., Cook, R. J., Gladman, D. D., Piguet, V., and Eder, L.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Infection & Immunity
• Research Centre: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
• Journal Name: Arthritis and Rheumatology
• Publisher: Wiley
• ISSN: 2326-5191
• ISSN (Online): 2326-5205
• Published Online: 08 March 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Arthritis and Rheumatology 74(7): 1184-1192
• Publisher Policy: Reproduced under a Creative Commons License