In the largest study to date investigating the relationship between severe psoriasis and coronary artery disease, researchers confirmed that patients with severe psoriasis are at higher cardiovascular risk. The results are published in the Journal of Investigative Dermatology.

Psoriasis is a chronic systemic inflammatory disease that affects1-3% of the world population. This study involved 503 patients with psoriasis and no clinical cardiovascular disease. The researchers revealed a high prevalence of coronary microvascular dysfunction in more than 30% of asymptomatic patients.

The findings shed light on the possible mechanism by which psoriasis increases the risk of cardiovascular complications, consistent with previous studies of cardiovascular disease in people suffering from chronic inflammatory conditions such as rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis.

It was found that the severity of psoriasis and the duration of the disease, as well as the presence of psoriatic arthritis, were associated with a lower index of CFR (coronary flow reserve), indicating coronary microvascular dysfunction. Furthermore, conventional cardiovascular risk factors such as tobacco use, hyperlipidemia, and diabetes mellitus were not independently associated with reduced CFR in patients with severe psoriasis. These findings highlight the importance of considering inflammation and psoriasis-related factors when assessing cardiovascular risk.

“We could hypothesize that an early and effective treatment of psoriasis would restore the microvascular dysfunction and ultimately prevent the future risk of myocardial infarction and heart failure associated with it”, points out the lead researcher, Stefano Piasserico, a doctor in the Dermatology Unit of of the Department of Medicine of the University of Padua, and adds: “Some preliminary studies have shown that coronary microvascular dysfunction is restored after treatment with biological drugs. Nevertheless, prospective studies are needed to confirm whether these findings translate into a reduction in cardiovascular events.”