Exploring the association between psoriasis and subclinical atherosclerosis defined by carotid intima-media thickness (CIMT) in patients with psoriasis vulgaris: a systematic review and meta-analysis

BackgroundPsoriasis is a chronic inflammatory condition that increases the risk of vascular issues, ranging from mild artery damage to severe events such as heart attacks and strokes. This systematic review and meta-analysis aimed to evaluate the relationship between psoriasis and carotid intima-media thickness (CIMT), a marker of subclinical atherosclerosis.MethodsA comprehensive search of Embase, PubMed/Medline, Scopus, and CINAHL via EBSCO was conducted up until June 2023 using the terms "Atherosclerosis AND Psoriasis." Studies measuring CIMT to assess atherosclerosis in psoriasis patients were included. A meta-analysis and subgroup analysis were performed to calculate the overall mean difference in CIMT between psoriasis patients and control groups. Studies published between 2009 and 2023 were reviewed, including 28 case-control, 18 cross-sectional, and two prospective cohort studies.ResultsThe total sample size was 15,914 participants, with individual study sizes ranging from 32 to 8271. Of the included studies, 44 revealed a significant association between psoriasis and CIMT, suggesting a higher risk of subclinical atherosclerosis in psoriasis patients. The meta-analysis found that psoriasis patients had a CIMT 0.17 mm higher than the control group (95% CI 0.12- 0.22). However, six studies did not show a statistically significant mean difference.ConclusionsThis study emphasizes the importance of assessing cardiovascular risk in psoriasis patients, particularly those with moderate-to-severe disease. It highlights the need for tailored interventions to manage the increased risk of atherosclerosis in this population.