Effects of Metabolic Syndrome on Cardiovascular Outcomes of Psoriatic Patients with Coronary Artery Disease: A Single Center Retrospective Cohort Study

Lin Zhao; Lin Sun; Kunqi Yang; Zuozhi Li; Yan Wang; Tianjie Wang; Man Wang; Yan Zeng; Xianliang Zhou; Weixian Yang

doi:10.2147/DMSO.S402618

Effects of Metabolic Syndrome on Cardiovascular Outcomes of Psoriatic Patients with Coronary Artery Disease: A Single Center Retrospective Cohort Study

Diabetes Metab Syndr Obes. 2023 Apr 10:16:1003-1012. doi: 10.2147/DMSO.S402618. eCollection 2023.

Authors

Lin Zhao^#¹, Lin Sun^#¹, Kunqi Yang¹, Zuozhi Li¹, Yan Wang¹, Tianjie Wang¹, Man Wang¹, Yan Zeng¹, Xianliang Zhou¹, Weixian Yang¹

Affiliation

¹ Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

^# Contributed equally.

Abstract

Background: Psoriasis is associated with an increased prevalence of cardiovascular risk factors, including metabolic syndrome (MetS). To date, it is unclear whether MetS causes differences in cardiovascular outcomes in psoriatic patients with coronary artery disease.

Methods: We conducted a retrospective cohort study to determine the effects of MetS in psoriatic patients with coronary artery disease. Comparisons were made between patients with and without MetS. Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between variables.

Results: Of the 307 psoriatic patients with coronary artery disease, 94 met criteria (30.6%) for MetS. Individuals with MetS were more likely to be female (p <0.001). Levels of platelet counts and high-sensitivity C-reactive protein were higher in the MetS group (p = 0.038 and 0.005, respectively). After a mean follow-up of 35.32 months, major adverse cardiovascular events (MACEs) and non-fatal myocardial infarction were more likely in the MetS than the non-MetS group (33.3% vs 20.6%, p = 0.02; 26.4% vs 15.7%, p = 0.032, respectively). Kaplan-Meier estimates showed the same trend. Cox regression analysis showed that MetS (hazard ratio 1.738; 95% confidence interval 1.045-2.891; p = 0.033) and left ventricular ejection fraction (hazard ratio 0.968; 95% confidence interval 0.945-0.991; p = 0.006) were associated with an increased risk of MACEs.

Conclusion: In psoriatic patients with coronary artery disease, MetS independently predicted MACEs. In addition, left ventricular ejection fraction was negatively associated with an increased risk of MACEs. To reduce the cardiovascular disease risk, it is necessary to increase awareness of MetS in psoriatic patients with coronary artery disease.

Keywords: MACEs; cardiovascular outcomes; coronary artery disease; metabolic syndrome; psoriasis.

Grants and funding

This work was supported by the Suzhou Industrial Park Xinxin Cardiovascular Health Foundation “Progress · Progress Fund 2020” funded project (2020-CCA-ACCESS-120), the National Natural Science Foundation of China (82192902), the CAMS Innovation Fund for Medical Sciences (CIFMS, 2022-I2M-C&T-A-010) and the National Key Research and Development Program of China (2016YFC1300100). The funding sources had no involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the article for publication.