The Association of Psoriatic Arthritis with Carotid Intima-Media Thickness

Document Type : Original Article


1 Associate Professor, Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

2 Associate Professor, Department of Community Medicine, Kashan University of Medical Sciences, Kashan, Iran

3 Assistant Professor, Autoimmune Diseases Research Center & Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

4 Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran

5 Associate Professor, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran


Background: Previous studies have showed that psoriatic arthritis increases the risk of cardiovascular disease and atherosclerosis. On the other hand, an increased carotid intima-media thickness can be associated with atherosclerosis. The present study aimed to evaluate the association between psoriatic arthritis and carotid intima-media thickness.
Methods: In this case-control study performed during 2018, 22 patients with psoriatic arthritis and 22 healthy controls matched for age and sex were participated. In all subjects, the carotid intima-media thickness was measured by ultrasonography. Systemic inflammatory markers, including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were assessed in psoriatic arthritis patients.
Results: The mean carotid intima-media thickness was 56±0.10 mm in the psoriatic arthritis patients and 54±0.07 mm in the control group with no significant difference (p=0.358). According to the regression analysis, carotid intima-media thickness had no positive correlation with age, sex and body mass index. The carotid intima-media thickness increased in psoriatic arthritis patients with increasing the duration of arthritis, disease activity (DAS-28), CRP, and ESR, but the correlations were not statistically significant.
Conclusion: The study findings do not support the previous reports that claimed a potential correlation between mean carotid intima-media thickness and psoriatic arthritis.


  1. Pelechas E, Kaltsonoudis E, Voulgari P, Drosos A. Illustrated Handbook of Rheumatic and Musculo-Skeletal Diseases. Switzerland: Springer; 2019. p. 93-119.
  2. Lloyd P, Ryan C, Menter A. Psoriatic arthritis: an update. Arthritis 2012; 2012:176298.
  3. Tam LS, Shang Q, Li EK, Tomlinson B, Chu TT, Li M, et al. Subclinical carotid atherosclerosis in patients with psoriatic arthritis. Arthritis Rheum 2008; 59(9):1322-31.
  4. Ramonda R, Lo Nigro A, Modesti V, Nalotto L, Musacchio E, Iaccarino L, et al. Autoimmun Rev 2011; 10(12):773-8.
  5. Carbone F, Bonaventura A, Liberale L, Paolino S, Torre F, Dallegri F, et al. Atherosclerosis in rheumatoid arthritis: promoters and opponents. Clin Rev Allergy Immunol 2018; 58(1):1-14.
  6. Upadhyay RK. Emerging risk biomarkers in cardiovascular diseases and disorders. J Lipids 2015; 2015:971453.
  7. Bańska-Kisiel K, Haberka M, Bergler-Czop B, Brzezińska-Wcisło L, Okopień B, Gąsior Z. Carotid intima-media thickness in patients with mild or moderate psoriasis. Postepy Dermatol Alergol 2016; 33(4):286-9.
  8. Weber LA, Cheezum MK, Reese JM, Lane AB, Haley RD, Lutz MW, et al. Cardiovascular imaging for the primary prevention of atherosclerotic cardiovascular disease events. Curr Cardiovasc Imaging Rep 2015; 8(9):36.
  9. Darabian S, Hormuz M, Latif MA, Pahlevan S, Budoff MJ. The role of carotid intimal thickness testing and risk prediction in the development of coronary atherosclerosis. Curr Atheroscler Rep 2013; 15(3):306.
  10. Yiu KH, Yeung CK, Zhao CT, Chan JC, Siu CW, Tam S, et al. Prevalence and extent of subclinical atherosclerosis in patients with psoriasis. J Intern Med 2013; 273(3):273-82.
  11. Balci DD, Balci A, Karazincir S, Ucar E, Iyigun U, Yalcin F, et al. Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis. J Eur Acad Dermatol Venereol 2009; 23(1):1-6.
  12. Yilmazer B, Sahin T, Unlu BO, Kir HM, Cefle A. Investigation of subclinical atherosclerosis in psoriatic arthritis patients with minimal disease activity. Rheumatol Int 2015; 35(8):1385-92.
  13. Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum 2006; 54(8):2665-73.
  14. Eder L, Zisman D, Barzilai M, Laor A, Rahat M, Rozenbaum M, et al. Subclinical atherosclerosis in psoriatic arthritis: a case-control study. J Rheumatol 2008; 35(5):877-82.
  15. Di Minno MN, Iervolino S, Peluso R, Scarpa R, Di Minno G; CaRRDs study group. Carotid intima-media thickness in psoriatic arthritis: differences between tumor necrosis factor-alpha blockers and traditional disease-modifying antirheumatic drugs. Arterioscler Thromb Vasc Biol 2011; 31(3):705-12.
  16. Kimhi O, Caspi D, Bornstein NM, Maharshak N, Gur A, Arbel Y, et al. Prevalence and risk factors of atherosclerosis in patients with psoriatic arthritis. Semin Arthritis Rheum 2007; 36(4):203-9.
  17. Mazlan SA, bin Mohamed Said MS, Hussein H, binti Shamsuddin K, Shah SA, Basri H. A study of intima media thickness and their cardiovascular risk factors in patients with psoriatic arthritis. Acta Medica (Hradec Kralove) 2009; 52(3):107-16.
  18. Contessa C, Ramonda R, Lo Nigro A, Modesti V, Lorenzin M, Puato M, et al. [Subclinical atherosclerosis in patients with psoriatic arthritis: a case-control study. Preliminary data]. Reumatismo 2009; 61(4):298-305. [In Italian].