Psoriatic Arthritis Features and Risk of Cardiovascular Events: A Nationwide Cohort Study.

objectiveThis study aimed to assess the specific clinical features of psoriatic arthritis as predictors of cardiovascular (CV) risk.

methodsData were drawn from the CorEvitas observational US registry database of 5,131 patients with psoriatic arthritis. Out of these, 3,696 were included because they had no history of a CV event and had at least one follow-up visit. Participant characteristics were assessed at baseline visits, and participants were tracked until their last follow-up visit or the occurrence of a CV event. The mean tracked follow-up time was 3.69 years (SD ±2.87). Dactylitis and enthesitis were designated as the primary predictors of CV events. Secondary predictors were tender and swollen joint counts, nail involvement, and psoriasis body surface area percentage. Baseline characteristics were compared between those with dactylitis vs. those without and those with enthesitis vs. those without, using Fisher's exact test for categorical variables and the Kruskal-Wallis test for continuous variables. Unadjusted Kaplan-Meier curves were estimated. Cox regression models estimated CV risk (hazard ratios).  Results and conclusion: No statistically significant association between designated predictors and the development of CV events was observed. Dactylitis was more prevalent in the group with enthesitis than in the group without enthesitis (p<0.001). Enthesitis was also more prevalent in the group with dactylitis than in the group without dactylitis (p<0.001). Numbers of tender and swollen joints were significantly increased both with dactylitis and enthesitis (p<0.001 for all four analyses). Our results contrast with prior studies reporting associations of dactylitis with CV events and enthesitis with CV risk.