Asymptomatic Hyperuricemia and Serum Uric Acid Concentration Correlate with Subclinical Atherosclerosis in Psoriatic Arthritis Patients Without Clinically Evident Cardiovascular Disease

Objective: To establish whether serum uric acid concentration correlates with carotid intima-media wall thickness (IMT) in a cohort of psoriatic arthritis (PsA) patients without overt cardiovascular (CV) disease or classic CV risk factors who attended a community hospital. Methods: A series of 52 PsA patients were assessed by carotid ultrasonography. Carotid IMT and carotid plaques were measured in the right common carotid artery. A correlation between serum uric acid concentration and carotid IMT was assessed and receiver operating characteristic curves to evaluate the ability of serum uric acid to predict carotid IMT > 0.90 mm and carotid plaques were performed. Results: PsA patients with hyperuricemia (n = 6 [11.5%]) had greater carotid IMT (mean +/- standard deviation: 0.89 +/- 0.20 mm) than those without hyperuricemia (n = 46 [89%]; 0.67 +/- 0.16 mm) (P = 0.01). Patients with carotid IMT 0.60 mm had lower mean serum uric acid levels (4.7 +/- 1.2 mg/dL) than those with greater carotid IMT (5.3 +/- 1.7 mg/dL for patients with carotid IMT 0.76-0.90 mm and 6.4 +/- 1.3 mg/dL for those with carotid IMT > 0.90 mm; P for trend = 0.02). A significant correlation between carotid IMT and serum uric acid concentration was observed (r = 0.337; P = 0.01). High serum uric acid levels were associated with an increased risk of having carotid IMT > 0.90 mm (Odds ratio = 2.66 [95% confidence interval: 1.08-6.53], P = 0.03, area under receiver operating characteristic curve: 0.80) or with the presence of carotid plaques (Odds ratio = 1.85 [95%; confidence interval: 1.01-3.38], P = 0.05, area under receiver operating characteristic curve: 0.72). Conclusions: In PsA patients without clinically evident CV disease there is a correlation between serum uric acid concentration and subclinical atherosclerosis. (C) 2009 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 39:157-162