The research team found
that biologic therapy using anti-inflammatory drugs for treating moderate to
can significantly reduce coronary
inflammation in patients suffering from this skin disorder.
The study used
a novel imaging biomarker called perivascular fat attenuation index (FAI),
which measured the effect of biologic therapy on reduction of coronary
inflammation. In fact, this is the first study using FAI to measure the effect
of biologic therapy on coronary inflammation.
The study has been published online in JAMA Cardiology
, a journal of the American Medical Association (AMA).
Psoriasis and its Impact on Coronary
Psoriasis is a
chronic skin condition that occurs due to a build-up of skin cells, which leads
to the formation of dry, scaly, inflamed, and itchy patches on the skin.
Psoriasis affects approximately 3-5 percent of people in the US, and is
associated with widespread systemic inflammation, which increases the risk of
often associated with immune responses targeted against infectious pathogens.
But the immune response can also attack the blood vessels, increasing chances
of blood clot formation, causing arterial blockage and eventually leading to
and stroke. Approximately 20-30 percent
of the US population is at risk of these types of cardiovascular events,
arising from inflammation.
The study was led
by Dr. Nehal N. Mehta, MD, MSCE, FAHA, who is a Lasker Clinical Research
Scholar and Head of the Laboratory of Inflammation and Cardiometabolic Diseases
at the National Heart, Lung, and Blood Institute (NHLBI), a constituent
institute of the National Institutes of Health (NIH), Bethesda, MD, USA.
The co-author of
the paper was Dr. Charalambos Antoniades, MD, PhD, who is a Professor of
Cardiovascular Medicine and Deputy Head of the Division of Cardiovascular
Medicine at the Radcliffe Department of Medicine, Medical Sciences Division,
University of Oxford, UK. He is also a Senior Clinical Fellow of the British
Salient Features of the Study
patients with moderate to severe psoriasis were included in the study
of the patients received biologic therapy for 3 months prior to the study
patients received biologic therapy (Intervention Group)
patients didn't receive biologic therapy (Control Group)
patients were recruited from the Psoriasis Atherosclerosis Cardiometabolic
Initiative cohort of NIH
patients underwent computed tomography (CT) scans at
the start of the study and after one year
inflammation was assessed using the perivascular fat attenuation index
reduction in coronary inflammation was observed in the Intervention Group
inflammation was also reduced in patients with pre-existing coronary
artery plaques following biologic therapy
was no change in the Control Group
Fat Attenuation Index (FAI) and its Prediction of
Future Cardiovascular Events
inflammation inhibits the deposition of perivascular fat (fat around the
arteries). This results in attenuation (reduction) of the fatty layer around
the coronary arteries. FAI is a novel imaging biomarker that is capable of
capturing coronary inflammation by spatial mapping changes in perivascular fat
attenuation on coronary CT angiography (CTA). The present study used FAI to
measure the effect of biologic therapy on coronary inflammation.
has a very high predictive power and is capable of predicting a person's risk
of life-threatening cardiovascular events, years ahead of conventional
"FAI is a new method of analyzing CT scans that can
predict a patient's risk of fatal heart attacks and other cardiac events years
in advance, and independent of other traditional risk factors for heart
explains Antoniades. "In
fact, our research has found that an abnormal perivascular FAI was linked to a
six- to nine-fold increased risk of major adverse cardiovascular events."
Implications of the Study
The present study has wide-ranging implications. The
research findings are not only applicable for psoriasis, but also other chronic
inflammatory diseases, such as systemic lupus erythematosus (SLE)
and rheumatoid arthritis
. Importantly, it
is well-established that these diseases increase the risk of heart attacks and
The research team
is highly optimistic that the high predictive power of FAI will greatly
facilitate in planning treatment well in advance. This could bring about a
revolutionary change, which will promote personalized
in cardiac care.
"Coronary inflammation offers important clues about
the risk of developing heart artery disease,"
says Mehta. "Our findings add to the growing body of
research that shows treating underlying inflammatory conditions may reduce the
risk of cardiovascular diseases."
The study was
funded by the NIH's National Heart, Lung, and Blood Institute (NHLBI),
Bethesda, MD, USA.
- Psoriasis therapy linked to reduced coronary inflammation in patients with the skin condition - (https://www.nhlbi.nih.gov/news/2019/psoriasis-therapy-linked-reduced-coronary-inflammation-patients-skin-condition)