Should all patients with psoriasis receive statins? Analysis according to different strategies
An. bras. dermatol
;
94(6): 691-697, Nov.-Dec. 2019. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-1054897
ABSTRACT
Abstract Background: Different strategies have been proposed for the cardiovascular risk management of patients with psoriasis. Objective: To estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy. Methods: A retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed. Results: A total of 892 patients (mean age 59.9 ± 16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1-27.0%) and 1.9% (IQR 0.4-5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies: 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively. Study limitations: This was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis. Conclusion: This population with psoriasis was mostly classified at moderate-high risk and the statin therapy indication was similar when applying the two strategies evaluated.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Psoriasis
/
Enfermedades Cardiovasculares
/
Inhibidores de Hidroximetilglutaril-CoA Reductasas
/
Anticolesterolemiantes
Tipo de estudio:
Estudio de etiología
/
Guía de Práctica Clínica
/
Estudio observacional
/
Factores de riesgo
Límite:
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
An. bras. dermatol
Asunto de la revista:
Dermatologia
Año:
2019
Tipo del documento:
Artículo
País de afiliación:
Argentina
Institución/País de afiliación:
Hospital Italiano de Buenos Aires/AR
/
Sociedad Argentina de Cardiología/AR
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