Self-reported depression in psoriasis is associated with subclinical vascular diseases

• Published in: Atherosclerosis Vol. 251; pp. 219 - 225
• Main Authors: Aberra, Tsion M, Joshi, Aditya A, Lerman, Joseph B, Rodante, Justin A, Dahiya, Asha K, Teague, Heather L, Ng, Qimin, Silverman, Joanna I, Sorokin, Alexander V, Salahuddin, Taufiq, Lockshin, Benjamin N, Ahlman, Mark A, Playford, Martin P, Chen, Marcus Y, Gelfand, Joel M, Mehta, Nehal N
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-08-2016
• Subjects: Anxiety; Cardiovascular; Cardiovascular Diseases - complications; Cohort Studies; Comorbidity; Computed Tomography Angiography; Coronary Vessels - pathology; Depression; Depression - complications; Depression - diagnosis; Female; Glomerular Filtration Rate; Humans; Inflammation; Male; Middle Aged; Multivariate Analysis; Positron Emission Tomography Computed Tomography; Psoriasis; Psoriasis - complications; Psoriasis - psychology; Risk Factors; Self Report; Severity of Illness Index; Subclinical cardiovascular disease; Tomography, X-Ray Computed; Vascular Diseases - complications; Vascular Diseases - diagnosis; Vascular Diseases - psychology; Depression; Anxiety; Inflammation; Subclinical cardiovascular disease; Psoriasis
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2016.05.043

Abstract Background and aims Psoriasis is a chronic inflammatory disorder associated with vascular inflammation, measured by 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG PET/CT), and an increased risk of myocardial infarction. Patients with psoriasis are also more likely to suffer from comorbid depression. Whether depression accelerates the development of subclinical atherosclerosis in psoriasis is unknown. Methods Patients were selected from within a larger psoriasis cohort. Those who reported a history of depression (N = 36) on survey were matched by age and gender to patients who reported no history of psychiatric illness (N = 36). Target-to-background ratio from FDG PET/CT was used to assess aortic vascular inflammation and coronary CT angiography scans were analyzed to determine coronary plaque burden. Multivariable linear regression was performed to understand the effect of self-reported depression on vascular inflammation and coronary plaque burden after adjustment for Framingham risk (standardized β reported). Results In unadjusted analyses, vascular inflammation and coronary plaque burden were significantly increased in patients with self-reported depression as compared to patients with psoriasis alone. After adjustment for Framingham Risk Score, vascular inflammation (β = 0.26, p  = 0.02), total plaque burden (β = 0.17, p  = 0.03), and non-calcified burden (β = 0.17, p  = 0.03) were associated with self-reported depression. Conclusions Self-reported depression in psoriasis is associated with increased vascular inflammation and coronary plaque burden. Depression may play an important role in promoting subclinical atherosclerosis beyond traditional cardiovascular risk factors.