Severe psoriasis is associated with a higher cardiovascular (CV) risk and subclinical coronary artery disease (CAD). In a recent article published in Actas Dermo-Sifiliográficas, researchers found that coronary artery calcium (CAC) testing may be effective for assessing subclinical CAD presence and severity and might be a feasible tool for CV risk reclassification in patients with severe psoriasis.

Researchers reported that more than 40% of patients with severe psoriasis from a low-risk region and up to 25% of patients in non‒high-risk categories have subclinical CAD.

The cross-sectional study included 111 patients from the Mediterranean region with severe chronic plaque psoriasis and low CV risk. Patients were stratified into 4 groups according to risk, as defined by European Society of Cardiology/European Atherosclerosis Society guidelines and HeartScore/SCORE calibrated charts. The investigators used coronary computed tomography imaging for CAC testing. Patients in the moderate-risk group who scored at least 100 were reclassified, and patients in the low-risk group who scored over 0 were also considered as reclassified.

According to the researchers, 46 patients (41.4%) exhibited subclinical CAD, of which 86.2% were in high/very-high-risk categories and 25.6% were in non‒high-risk categories.

CAC testing identified 14 patients (17.1%) in the low- or moderate-risk groups for risk reclassification. When considered alone, the moderate-risk group had a higher proportion of reclassification (25%) compared to the low-risk group (13.8%). Researchers found that age was related to the presence of subclinical CAD and risk reclassification.

Overall, the study’s findings supported the use of CAC testing to characterize CV risk in patients with psoriasis.

Reference: Martinez-Domenech A, Forner Giner J, Pérez-Pastor G, Magdaleno-Tapial J, Herraez-Cervera B, Sánchez-Carazo JL, et al. Performance of coronary artery calcium testing in patients with severe psoriasis: risk assessment and reclassification potential in a low cardiovascular risk population. Actas Dermosifiliogr. 2022;S0001-7310(22)00332-5. doi:10.1016/