Should all patients with psoriasis receive statins? Analysis according to different strategies.
Adult
Aged
Anticholesteremic Agents
/ therapeutic use
Cardiovascular Diseases
/ etiology
Cholesterol
/ blood
Diabetes Complications
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Male
Middle Aged
Practice Guidelines as Topic
Psoriasis
/ complications
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Triglycerides
/ blood
Hydroxymethylglutaryl-CoA reductase inhibitors
Lipids
Psoriasis
Journal
Anais brasileiros de dermatologia
ISSN: 1806-4841
Titre abrégé: An Bras Dermatol
Pays: Spain
ID NLM: 0067662
Informations de publication
Date de publication:
Historique:
received:
13
12
2018
accepted:
28
03
2019
pubmed:
4
12
2019
medline:
15
1
2020
entrez:
3
12
2019
Statut:
ppublish
Résumé
Different strategies have been proposed for the cardiovascular risk management of patients with psoriasis. To estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy. A retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed. A total of 892 patients (mean age 59.9±16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1-27.0%) and 1.9% (IQR 0.4-5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies: 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively. This was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis. This population with psoriasis was mostly classified at moderate-high risk and the statin therapy indication was similar when applying the two strategies evaluated.
Sections du résumé
BACKGROUND
BACKGROUND
Different strategies have been proposed for the cardiovascular risk management of patients with psoriasis.
OBJECTIVE
OBJECTIVE
To estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy.
METHODS
METHODS
A retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed.
RESULTS
RESULTS
A total of 892 patients (mean age 59.9±16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1-27.0%) and 1.9% (IQR 0.4-5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies: 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively.
STUDY LIMITATIONS
CONCLUSIONS
This was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis.
CONCLUSION
CONCLUSIONS
This population with psoriasis was mostly classified at moderate-high risk and the statin therapy indication was similar when applying the two strategies evaluated.
Identifiants
pubmed: 31789271
pii: S0365-0596(19)30066-2
doi: 10.1016/j.abd.2019.03.001
pmc: PMC6939080
pii:
doi:
Substances chimiques
Anticholesteremic Agents
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Triglycerides
0
Cholesterol
97C5T2UQ7J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
691-697Informations de copyright
Copyright © 2019. Published by Elsevier España, S.L.U.
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