Highlights
- •Patients with psoriasis are at increased risk for cardiovascular disease.
- •Depression is associated with an elevated risk of cardiovascular events.
- •Depression is a common comorbidity in psoriasis.
- •Comorbid depression is associated with increased subclinical atherosclerosis.
- •Framingham risk cannot fully explain vascular disease seen in comorbid depression.
Abstract
Background and aims
Psoriasis is a chronic inflammatory disorder associated with vascular inflammation,
measured by 18-fluorodeoxyglucose positron emission tomography/computed tomography
(18-FDG PET/CT), and an increased risk of myocardial infarction. Patients with psoriasis
are also more likely to suffer from comorbid depression. Whether depression accelerates
the development of subclinical atherosclerosis in psoriasis is unknown.
Methods
Patients were selected from within a larger psoriasis cohort. Those who reported a
history of depression (N = 36) on survey were matched by age and gender to patients
who reported no history of psychiatric illness (N = 36). Target-to-background ratio
from FDG PET/CT was used to assess aortic vascular inflammation and coronary CT angiography
scans were analyzed to determine coronary plaque burden. Multivariable linear regression
was performed to understand the effect of self-reported depression on vascular inflammation
and coronary plaque burden after adjustment for Framingham risk (standardized β reported).
Results
In unadjusted analyses, vascular inflammation and coronary plaque burden were significantly
increased in patients with self-reported depression as compared to patients with psoriasis
alone. After adjustment for Framingham Risk Score, vascular inflammation (β = 0.26,
p = 0.02), total plaque burden (β = 0.17, p = 0.03), and non-calcified burden (β = 0.17, p = 0.03) were associated with self-reported depression.
Conclusions
Self-reported depression in psoriasis is associated with increased vascular inflammation
and coronary plaque burden. Depression may play an important role in promoting subclinical
atherosclerosis beyond traditional cardiovascular risk factors.
Keywords
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Article info
Publication history
Published online: May 27, 2016
Accepted:
May 26,
2016
Received in revised form:
May 21,
2016
Received:
March 29,
2016
Identification
Copyright
Published by Elsevier Ireland Ltd.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Inflammation, depression and atherosclerosis or depression, inflammation and atherosclerosis?AtherosclerosisVol. 251
- PreviewIn their paper published in Atherosclerosis, Aberra et al. [1] describe an association between depression, inflammation and subclinical atherosclerosis in 36 patients with psoriasis and self-reported depression and 36 patients affected by psoriasis but without history of depression matched for risk factors. In an elegant design, they performed positron emission tomography/computed tomography (PET/CT) with fluorideoxyglucose (FDG) to detect inflammation in the aorta and CT angiography of the coronary arteries.
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