ArticleACR open rheumatology2026
Neutrophil-to-Lymphocyte Ratio as a Predictor of Cardiovascular Events in Psoriatic Disease: A Retrospective Cohort Study.
Article in ACR open rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
objectiveThe aim of this study was to evaluate the neutrophil-to-lymphocyte ratio (NLR) as an independent predictor of major adverse cardiovascular events (MACEs) and all-cause mortality in patients with psoriasis (PsO) or psoriatic arthritis (PsA).
methodsWe conducted a retrospective cohort study of 967 patients (825 with PsO and 142 with PsA) at a large university hospital in Buenos Aires, Argentina. The NLR was calculated at study entry and after 6 to 12 months of treatment with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) or biologic/targeted synthetic DMARDs for those patients receiving treatment. The primary outcomes were incident MACEs (nonfatal stroke, nonfatal myocardial infarction, or cardiovascular death) and all-cause mortality. Secondary outcomes included treatment effects on NLR and correlation with disease activity.
resultsDuring a mean follow-up period of 14 years, 67 MACEs and 97 deaths occurred. Baseline NLR >2.5 was associated with an increased risk of MACEs (hazard ratio 1.67, 95% confidence interval 1.00-2.77, P = 0.048) after adjusting for a validated composite cardiovascular risk score, sex, and systemic treatment. The all-cause mortality risk was higher among patients with an elevated NLR; however, the significance was lost after adjustment. Biologic therapy reduced the proportion of patients with an elevated NLR from 30.1% to 15.7% after 6 to 12 months of treatment.
conclusionBaseline NLR is a simple and universally available biomarker associated with increased cardiovascular risk in psoriatic disease, providing incremental value beyond established cardiovascular risk scores.
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