Protein may indicate atherosclerosis risk in patients with psoriatic disease
Click Here to Manage Email Alerts
The presence of cardiac troponin I may indicate a risk for atherosclerosis in patients with psoriatic disease independently from traditional cardiovascular risk factors, according to data published in Arthritis and Rheumatology.
“While findings from general population cohort studies indicate that cardiac high-sensitivity troponin I (cTnI) and N-terminal pro-brain-type natriuretic peptide (NT-proBNP) are strong predictors of CV risk, limited information exists in patients with rheumatic diseases and particularly in those with [psoriatic disease (PsD)],” Keith Colaço, MSc, of the Women’s College Hospital, in Toronto, and colleagues wrote.
“In the context of current treatment guidelines highlighting the need to identify patients with PsD who are at high CV risk, we determined whether these cardiac biomarkers predict clinical CV events independently of traditional CV risk factors and whether they improve CV risk stratification beyond the [ Framingham Risk Score (FRS)],” they added.
To examine whether certain biomarkers are indicative of carotid plaque burden and cardiovascular risk, Colaço and colleagues conducted a nested cohort study of patients included within the University of Toronto PsD cohort. The cohort included 358 patients who underwent a baseline carotid ultrasound between 2009 and 2015, as well as a second ultrasound assessment 2 to 3 years after the baseline measurement. The burden of atherosclerotic plaques was measured by carotid total plaque area.
To determine the FRS for each patient, the researchers considered age, sex, smoking habits, systolic blood pressure, hypertension treatment, diabetes, total cholesterol and high-density lipoprotein cholesterol. The occurrence of the first clinical cardiovascular event served as the primary endpoint.
In the analysis investigating the relationship between biomarkers and cardiovascular events, both cTnI (HR = 3.02; 95% CI, 1.12-8.16) and NT-proBNP (HR = 2.02; 95%; CI, 1.28-3.18) were associated with cardiovascular events per 1 standard deviation increase, according to the researchers. In addition, they observed a nonlinear relationship between the biomarkers and cardiovascular events.
Following analysis, both cTnI (beta coefficient = 0.52; 95% CI, 0.3-0.74) and NT-proBNP (beta coefficient = 0.24; 95% CI, 0.1-0.39) were correlated with carotid total plaque area. The researchers found no improvement in predictive performance when comparing the model using FRS alone with a model employing the FRS with cardiac biomarkers.
“This study established the association between elevated cardiac biomarkers, atherosclerosis and clinical CV events in patients with PsD,” Colaço and colleagues wrote. “Both cTnI and NT-proBNP are associated with incident CV events independent of traditional CV risk factors and may reflect the excess risk in patients with PsD.
“However, the lack of improvement in prediction metrics beyond the FRS does not support the routine use of these cardiac biomarkers for CV risk stratification in asymptomatic patients with PsD,” they added. “These data encourage additional research evaluating the utility of c TnI and NT-proBNP in CV risk stratification of this patient population.”
Collapse
Read more about
Click Here to Manage Email Alerts