Epicardial adipose tissue volume is greater in men with severe psoriasis implying increased cardiovascular disease risk: A cross-sectional study.

Abstract Background Psoriasis confers elevated risk of coronary-artery disease. Objective Do patients with severe psoriasis have larger epicardial adipose tissue volumes (EAT-V) that are associated with cardiovascular risk? Methods For this cross-sectional study, we recruited dermatology patients with severe psoriasis and control patients without psoriasis or rheumatologic disease themselves or in a first-degree relative. Participants, age 34-55 years without known coronary-artery disease or diabetes mellitus, underwent computed tomography (CT); EAT-V was obtained from non-contrast-CT heart images. Results Twenty-five patients with psoriasis (14 men, 11 women) and 16 controls (5 men, 11 women) participated. Groups had no statistical difference in age; body-mass index; various cardiovascular risk factors (except hs-CRP in men); CT-determined coronary-artery calcium scores or plaque; or family history of premature cardiovascular disease. Mean EAT-V was greater in the psoriasis group compared to controls (P=.04). There was no statistical difference among women; however, male patients with psoriasis had significantly more EAT-V than controls (P=.03), even when corrected for elevated hs-CRP (P=.05). Limitations A single-center convenience sample may not be representative. Conclusions Males with psoriasis without known coronary disease or diabetes had greater EAT-V than controls. EAT-V may be an early identifier of those at increased risk for cardiovascular events. (J Am Acad Dermatol 2021;XX:xxx-xxx)