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Psoriatic arthritis and sacroiliitis are associated with increased vascular inflammation by 18fluorodeoxyglucose positron emission tomography computed tomography: baseline report from the Psoriasis Atherosclerosis and Cardiometabolic Disease Initiative.
MedLine Citation:
PMID:  25078679     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Psoriasis and psoriatic arthritis (PsA) increase cardiovascular disease (CVD) risk, yet surrogate markers for CVD in these disorders are inadequate. Since the presence of sacroiliitis may portend more severe PsA, we hypothesized that sacroiliitis by computerised tomography (CT) scan would be associated with increased vascular inflammation by 18fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT), which is an established measure of CVD.
METHODS: Subjects (n = 65) underwent whole-body FDG-PET/CT scans. Metabolic activity of the aorta was measured using the maximal standardized uptake value (SUVmax), a measure of atherosclerotic plaque activity. The primary outcome was aortic vascular inflammation. Linear regression (beta-coefficient (beta) and P value reported for PsA and sacroiliitis) was used to adjust for CVD risk factors to determine associations between PsA or sacroiliitis and vascular inflammation. Likelihood-ratio testing was performed to evaluate the contribution of sacroiliitis to vascular disease estimation beyond PsA and traditional CVD risk factors.
RESULTS: Vascular inflammation (mean +/- SD SUVmax) was greater (P < 0.001) in patients with sacroiliitis (7.33 +/- 2.09) by CT scan compared to those without (6.39 +/- 1.49) sacroiliitis (P = 0.038). There was an association between PsA and aortic inflammation (beta 0.124, P <0.001) and between sacroiliitis and aortic inflammation (beta 0.270, P < 0.001) after adjusting for CVD risk factors. Sacroiliitis predicted vascular inflammation beyond PsA and CVD risk factors (chi2 124.6, P < 0.001).
CONCLUSIONS: Sacroiliitis is associated with increased vascular inflammation by FDG-PET/CT, suggesting that sacroiliac joint disease may identify patients at greater risk for CVD. Large, ongoing prospective studies will be required to confirm these findings.
Shawn Rose; Jenny Dave; Corina Millo; Haley B Naik; Evan L Siegel; Nehal N Mehta
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-30
Journal Detail:
Title:  Arthritis research & therapy     Volume:  16     ISSN:  1478-6362     ISO Abbreviation:  Arthritis Res. Ther.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101154438     Medline TA:  Arthritis Res Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  R161     Citation Subset:  -    
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