Cardiovascular Risk in Patients With Psoriasis: JACC Review Topic of the Week.
Cardiovascular Risk in Patients With Psoriasis: JACC Review Topic of the Week.
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DOI：
10.1016/j.jacc.2021.02.009
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发表时间：
2021-04-06
影响因子：
24
通讯作者：
Berger JS
中科院分区：
文献类型：
--
作者：
Garshick MS;Ward NL;Krueger JG;Berger JS
牛皮癣是一种慢性炎症性皮肤病，影响美国2%-3%的人口。银屑病的免疫反应包括T细胞和髓样细胞的激活，血小板的激活，干扰素、肿瘤坏死因子-α和白介素6的上调，这些细胞因子与血管炎症和动脉粥样硬化的发展有关。银屑病患者患心血管疾病的可能性高达50%，而且这种心血管疾病的风险随着皮肤严重程度的增加而增加。主要的社会指南现在提倡将牛皮癣的诊断纳入心血管风险预测和预防策略。虽然注册数据表明，针对牛皮癣皮肤病的治疗可以减少血管炎症、冠状动脉斑块负担，并可能降低心血管风险，但随机安慰剂对照试验迄今尚未得出结论。需要进一步的研究来确定传统的心血管危险因素目标，降脂和抗血小板治疗的最佳作用，以及有针对性的银屑病治疗对心血管危险的影响。牛皮癣是一种慢性炎症性皮肤病，与心血管(CV)风险增加有关。银屑病的炎症环境包括T细胞、髓系细胞和细胞因子，如干扰素、肿瘤坏死因子-α、白介素2、白介素23、白介素17和白介素6，这些细胞因子与动脉粥样硬化的形成有关。指南现在建议将牛皮癣的诊断纳入心血管风险预测和预防策略。虽然观察数据表明银屑病的治疗可以降低心血管风险，但评估降低心血管风险的治疗方法的随机对照试验并不是决定性的。需要进一步的研究来确定银屑病皮肤病的CV、危险因素、目标和控制程度。
Psoriasis is a chronic inflammatory skin disease, which affects 2-3% of the U.S. population. The immune response in psoriasis includes enhanced activation of T cells and myeloid cells, platelet activation, and upregulation of interferons, tumor necrosis factor-α, and interleukin (IL)s IL-23, IL-17, and IL-6, which are linked to vascular inflammation and atherosclerosis development. Patients with psoriasis are up to 50% more likely to develop cardiovascular disease (CV) disease, and this CV risk increases with skin severity. Major society guidelines now advocate incorporating a psoriasis diagnosis into CV risk prediction and prevention strategies. While registry data suggest treatment targeting psoriasis skin disease reduces vascular inflammation, coronary plaque burden, and may reduce CV risk, randomized placebo-controlled trials are inconclusive to date. Further studies are required to define traditional CV risk factor goals, the optimal role of lipid-lowering and antiplatelet therapy, and targeted psoriasis therapies on CV risk. Psoriasis is a chronic inflammatory skin disease linked to enhanced cardiovascular (CV) risk. The inflammatory milieu in psoriasis includes T-cells, myeloid cells, and cytokines such as interferons, TNF-α, and the interleukin (IL)s IL-23, IL-17, and IL-6, which are linked to atherosclerosis development. Guidelines now suggest incorporating a psoriasis diagnosis into CV risk prediction and prevention strategies. While observational data suggests treatment of psoriasis can reduce CV risk, randomized controlled trials assessing treatments to reduce CV risk are inconclusive. Further studies are required to define CV risk factor goals and degree of psoriasis skin disease control.
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