Subclinical Cardiovascular Disease in Psoriatic Disease

NYU Langone Health63 enrolled

Overview

This study will look at how chronic inflammation seen in psoriatic disease translates into the increased atherosclerotic and thrombotic risk and how treatment reduces this CVD risk. The Aim of this study is to 1) Evaluate the association between moderate to severe psoriatic disease and measures of vascular function. 2) Evaluate the association between moderate to severe psoriatic disease and measures of thrombotic risk. 3) Understand how traditional medications used in cardiovascular disease (CVD) prevention such as aspirin and statins affect vascular function and thrombotic risk in those with moderate to severe psoriatic disease.

Cardiovascular disease (CVD) remains the leading cause of death in the US. Five modifiable risk factors: smoking, hyperlipidemia, diabetes, hypertension and obesity, account for 50% of CVD mortality between the ages of 45 - 79.1 These traditional cardiac risk factors dictate who to treat with primary prevention measures but do not take into account patient-specific disease states such as psoriatic disease including psoriasis and psoriatic arthritis, which predispose to chronic inflammation. Patients with psoriatic disease have an increased risk of atherosclerotic heart disease and myocardial infarctions compared to matched controls.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Cardiovascular Diseases

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Subjects with a history of moderate to severe psoriatic disease * Group 2: Healthy subjects without known psoriatic disease or cardiovascular disease Exclusion Criteria: * Unable to speak Spanish or English * Active smoking (within the past year) * Autoimmune, rheumatologic or inflammatory disease which are not psoriasis or psoriatic arthritis * Known active cancer receiving treatment * Pregnancy * Anemia (hemoglobin \< 9 mg/dl) or thrombocytopenia (Platelet count \<75), or thrombocytosis (Platelet count \>600) * A history of severe bleeding or bleeding disorders * Current medication use which interact with either aspirin or atorvastatin * Chronic kidney disease (CrCl \< 30ml/min) * Congestive heart failure * Currently taking aspirin or a statin. * NSAID use within the past 48 hours

Outcomes

Primary Outcomes

Mean Fold Change in Brachial Vein Endothelial Inflammatory Transcript

Endothelial sampling coupled to real-time PCR analysis will be used to monitor brachial vein endothelial inflammation

Time frame: Baseline, 5 Months

Secondary Outcomes

Fold Change Change in Composite Endothelial Inflammation

Endothelial inflammation will be monitored after 2 weeks of aspirin 81mg therapy

Time frame: Baseline (pre-Aspirin), 2 weeks (post-Aspirin)

Fold Change in Composite Endothelial Inflammation

Endothelial inflammation will be monitored after 2- weeks of 40mg of atorvastatin therapy.

Time frame: Baseline (pre-Atorvastatin), 2 weeks (post-Atorvastatin)

Change in Levels of Circulating Thromboxane B2

Platelet activation is measured by levels of circulating thromboxane b2, which will be measured after 2- weeks of aspirin 81mg therapy