Amit K Dey1, Heather L Teague1, Nicholas H Adamstein2, Justin A Rodante1, Martin P Playford1, Marcus Y Chen1, David A Bluemke3, Joel M Gelfand4, Paul M Ridker2, Nehal N Mehta5. 1. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. 2. Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, MA, USA. 3. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 4. Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA. 5. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address: nehal.mehta@nih.gov.
Abstract
BACKGROUND: Inflammation in the form of elevated high-sensitivity c-reactive protein (hs-CRP) has been shown to be critical in the development of atherothrombosis. Psoriasis, a chronic inflammatory skin disease, is associated with high systemic-inflammation, elevated neutrophil-to-lymphocyte ratio (NLR) and accelerated non-calcified coronary artery burden (NCB) by coronary computed tomography angiography (CCTA). We hypothesized that NLR would associate with early, rupture-prone atherosclerosis assessed as NCB independent of hs-CRP. METHODS: 316 consecutive psoriasis participants were recruited with 233 having one-year follow-up as part of a prospective, observational cohort study design. CCTA scans were performed to assess NCB in all three major epicardial coronary arteries. RESULTS: Patients with above average NLR (>mean: 2.29 ± 1.21) were older (mean ± SD; 52.0 ± 12.8 vs. 47.9 ± 12.6, p = 0.002), had higher hs-CRP (med. IQR: 2.3 (0.9-7.3) vs. 1.4 (0.7-3.2), p = 0.001) and had higher NCB (mean ± SD; 1.21 ± 0.58 vs. 1.13 ± 0.49, p = 0.018) when compared to patients with below average NLR. NLR associated with psoriasis area severity index score (β = 0.14, p = 0.017), hs-CRP (β = 0.16, p = 0.005), as well as NCB independent of traditional risk factors, body mass index, statin use and hs-CRP (β = 0.08, p = 0.009). One year of biologic therapy for psoriasis was associated with a reduction in NLR (-14.5%, p < 0.001), and this change in NLR associated with change in NCB in fully adjusted models and beyond hs-CRP (β = 0.17, p = 0.002). CONCLUSION: NLR associated with psoriasis severity, hs-CRP and NCB at baseline. Biologic therapy reduced NLR over time and this change in NLR associated with the change in NCB at one-year. Taken together, these findings suggest that NLR may capture psoriasis patients at higher risk of NCB due to residual inflammation not fully captured by hs-CRP. Published by Elsevier Inc.
BACKGROUND: Inflammation in the form of elevated high-sensitivity c-reactive protein (hs-CRP) has been shown to be critical in the development of atherothrombosis. Psoriasis, a chronic inflammatory skin disease, is associated with high systemic-inflammation, elevated neutrophil-to-lymphocyte ratio (NLR) and accelerated non-calcified coronary artery burden (NCB) by coronary computed tomography angiography (CCTA). We hypothesized that NLR would associate with early, rupture-prone atherosclerosis assessed as NCB independent of hs-CRP. METHODS: 316 consecutive psoriasis participants were recruited with 233 having one-year follow-up as part of a prospective, observational cohort study design. CCTA scans were performed to assess NCB in all three major epicardial coronary arteries. RESULTS: Patients with above average NLR (>mean: 2.29 ± 1.21) were older (mean ± SD; 52.0 ± 12.8 vs. 47.9 ± 12.6, p = 0.002), had higher hs-CRP (med. IQR: 2.3 (0.9-7.3) vs. 1.4 (0.7-3.2), p = 0.001) and had higher NCB (mean ± SD; 1.21 ± 0.58 vs. 1.13 ± 0.49, p = 0.018) when compared to patients with below average NLR. NLR associated with psoriasis area severity index score (β = 0.14, p = 0.017), hs-CRP (β = 0.16, p = 0.005), as well as NCB independent of traditional risk factors, body mass index, statin use and hs-CRP (β = 0.08, p = 0.009). One year of biologic therapy for psoriasis was associated with a reduction in NLR (-14.5%, p < 0.001), and this change in NLR associated with change in NCB in fully adjusted models and beyond hs-CRP (β = 0.17, p = 0.002). CONCLUSION: NLR associated with psoriasis severity, hs-CRP and NCB at baseline. Biologic therapy reduced NLR over time and this change in NLR associated with the change in NCB at one-year. Taken together, these findings suggest that NLR may capture psoriasis patients at higher risk of NCB due to residual inflammation not fully captured by hs-CRP. Published by Elsevier Inc.
Authors: Joseph F Merola; Iain B McInnes; Atul A Deodhar; Amit K Dey; Nicholas H Adamstein; Erhard Quebe-Fehling; Maher Aassi; Michael Peine; Nehal N Mehta Journal: Rheumatol Ther Date: 2022-03-19
Authors: Hannah Kaiser; Xing Wang; Amanda Kvist-Hansen; Martin Krakauer; Peter Michael Gørtz; Benjamin D McCauley; Lone Skov; Christine Becker; Peter Riis Hansen Journal: Sci Rep Date: 2021-11-02 Impact factor: 4.379