Higher disease activity and quality of life impairment are associated with increased carotid plaque in psoriatic arthritis patients

Abstract Background Psoriatic arthritis (PsA) is a chronic inflammatory joint disease often associated with psoriasis, significantly reducing patients' quality of life (QoL). Beyond its direct impact, PsA is linked to comorbidities like obesity, depression, and metabolic syndrome, which further worsen disease activity and QoL. Managing pain, functional capacity, social participation, fatigue, and psychological distress is essential for improving outcomes. The Psoriatic Arthritis Impact of Disease 12-item (PsAID-12) questionnaire, developed by EULAR, is a validated tool for assessing PsA's impact on QoL. This study examines the association between disease burden (PsAID-12) and carotid plaque (CP) prevalence to inform treatment strategies. Purpose Evaluate the association between disease activity impact on QoL, as measured by the PsAID12 questionnaire, and the prevalence of CP in patients with PsA. Methods Cross-sectional and comparative study that included PsA patients aged 30 to 75 who fulfilled the 2006 CASPAR Classification Criteria. Patients with previous CV disease, overlap syndrome, or pregnancy were excluded. Carotid ultrasound was performed on all study participants. The presence of CP was defined as diffuse carotid intima-media thickness (cIMT) ≥1.2 mm or focal thickness ≥0.5 mm. Subclinical atherosclerosis was defined as the presence of CP or an increased cIMT (≥0.8mm). Quality of life was evaluated using the psAID12 questionnaire. Patients were categorized into two groups based on their PsAID12 score, with a score of ≥ 4 indicating high disease impact. The Kolmogorov–Smirnov test was employed to determine normality. Comparisons with Chi-square and T- or Mann Whitney’s U-test, accordingly. A p-value of ≤0.05 was considered statistically significant. Results A total of 45 PsA patients were included, with a mean age of 51.9 ± 12.6 years and a mean disease duration of 12.5 years. The average PsAID12 score for all patients was 2.95 ± 2.31. Dyslipidemia was the most prevalent CV risk factor, affecting 46.6% of patients (n = 21). No significant differences were observed in other CV risk factors between groups. Patients with PsAID12 ≥ 4 showed significantly higher DAPSA scores compared to those with PsAID12 4 (35 vs. 16.2, p = 0.003), as well as a notably greater prevalence of CP (73.3% vs. 23.3%, p= 0.002). Correlation analysis demonstrated a significant positive relationship between DAPSA and PsAID12 scores (Pearson’s r = 0.54, p 0.001), indicating that higher disease activity is strongly associated with a greater impact on QoL, as measured by the PsAID12 questionnaire. Conclusion Our study highlights a strong association between disease activity and QoL in PsA, with higher disease activity correlating with increased PsAID12 scores and a greater prevalence of CP. Routine cardiovascular assessments, such as carotid ultrasound, are essential in managing PsA patients with significant disease impact.Table 1 Figure 1