Endocrine Abstracts

Background: Psoriasis is associated with a heightened prevalence of cardiovascular risk factors, including diabetes. However, it is not clear whether diabetes will cause differences on clinical outcomes of psoriatic patients who have already suffered from coronary artery disease.

Methods: We conducted a retrospective cohort study of consecutive psoriatic patients with coronary artery disease between January 2017 and May 2022 in our hospital. The clinical records, laboratory measurements and coronary angiography reports were collected, and comparisons were made between patients with and without diabetes. The Cox regression analysis and Kaplan-Meier survival analysis were used to evaluate the association between diabetes and major adverse cardiovascular events (MACEs).

Results: Of the 307 participants, 147 patients had diabetes. Individuals with diabetes were more prone to be with hypertension (P=0.045), history of stroke (P=0.041) and peripheral vascular disease (P=0.043). The levels of low-density lipoprotein cholesterol (P=0.039), uric acid (P=0.013) and homocysteine (P=0.006) were higher in the non-diabetes group. Patients with diabetes were more likely to have lesions in the right coronary artery than those without diabetes(P=0.03). After the mean follow-up of 35.32±18.61 months, MACEs were more prone to occur in diabetes group than non-diabetes group (30.0% vs 19.2%, P=0.032). Kaplan-Meier estimates showed the same trend. The COX regression analysis showed that diabetes [hazard ratio (HR)=1.661, 95% confidence interval (95%CI): 1.025–2.692, P=0.039] was positively associated with an increased risk of MACEs. In the subgroup analysis, diabetes was associated with the occurrence of MACEs especially in men (P=0.008) and in patients without chronic kidney disease(P=0.021).

Conclusion: In psoriatic patients with coronary artery disease, patients with diabetes were more likely to have lesions in the right coronary artery and diabetes can independently predict MACEs, especially in men and in patients without chronic kidney disease. To reduce the cardiovascular disease risk associated with diabetes, it is vital to increase awareness of the condition among these patients.