What is the clinical evidence from this study?

Study design: Case-Control. Population: Psoriasis (n=72). Intervention: Psoriasis vs. Healthy controls. Primary outcome: P-wave dispersion (PWD) (p=0.022).

March 1, 2021Open Access

Echocardiographic and electrocardiographic assessments in patients with psoriasis.

Q: What does this research mean for the field?

Patients with psoriasis exhibit significantly higher P-wave dispersion and a higher prevalence of abnormal pulmonary artery pressure compared to healthy controls. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Patients with psoriasis exhibited significantly higher P-wave dispersion (40.72 vs 35.11 msec, p=0.022) and a higher prevalence of abnormal pulmonary artery pressure compared to healthy controls.

Study Design

Type

Case-Control (n=72)

Blinding

Single-blind

Multicenter

Structured PICO

Does psoriasis increase the risk of echocardiographic and electrocardiographic abnormalities in patients without underlying cardiovascular disease?

Population

72 adults (36 with biopsy-confirmed psoriasis and 36 healthy controls) without underlying cardiovascular disease, evaluated for electrocardiographic and echocardiographic changes.

Exposure

Psoriasis (observational exposure)

Comparator

Healthy controls matched for age, sex, and socio-economic status

Outcome

Echocardiographic markers (left ventricular ejection fraction, diastolic function, hypertrophy, valvular defects, pulmonary artery pressure) and electrocardiographic P-wave dispersion (PWD)surrogate

Psoriasis is associated with increased P-wave dispersion and higher pulmonary artery pressure, suggesting an increased susceptibility to atrial fibrillation and vascular changes.

Main Result

Absolute Event Rate: 40.72% vs 35.11%

p-value: p=0.022

Limitations

Small sample size, particularly for moderate and severe psoriasis cases
Potential confounding from unknown baseline characteristics for arrhythmia risk factors
Study powered only for P-wave dispersion, potentially underpowered for left ventricular function differences

Abstract

BACKGROUND: Psoriasis is a chronic inflammatory disease affecting many organs. Recent studies have demonstrated that psoriasis is associated with cardiovascular disorders. We investigated the echocardiographic and conduction system changes in psoriasis patients. METHODS: In this case-control study, 36 psoriatic patients and 36 healthy controls were enrolled. Demographic and clinical data, echocardiographic and P wave dispersion (PWD) in 12-lead electrocardiogram were evaluated in both groups. We recruited patients with confirmed diagnosis via biopsy and have not been under recent systemic treatment. Patients with underlying cardiovascular disease were excluded from the study. RESULTS: Mean age was 41.56±16.20 and 39.67±13.85 year in case and control groups, respectively. There was no significant difference in the baseline characteristics of the two groups. PWD was significantly higher in the case group (p<0.05). High pulmonary artery pressure was observed in 14 psoriatic patients and 1 individual in the control group (p<0.001). Left ventricular diastolic dysfunction was significantly higher among individuals who were above 60 years of age (p<0.01) but not significantly different between the two groups. CONCLUSION: Psoriatic patients are more susceptible to future development of atrial fibrillation because of higher PWD. There is no significant difference between the diastolic function in these patients.

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