Classical monocyte frequency associated with non-calcified coronary plaque burden by CCTA in psoriasis

Authors

• M Aksentijevich
• HL Teague
• AK Dey
• YA Elnabawi
• J Groenendyk
• E Stansky
• J Silverman
• M Svirydava
• AS Reddy
• S Rose
• P Dagur
• J Philip McCoy Jr
• MP Playford
• V Sandfort
• MY Chen
• JM Gelfand
• DA Bluemke
• NN Mehta

Abstract

Background and Aims: Psoriasis, a chronic systemic inflammatory disease, is associated with elevated cardiovascular disease (CV) risk beyond traditional risk factors and thus provides a reliable human model to understand the role of monocytes in vascular disease. Recently, we showed that psoriasis is associated with increased sub-clinical CV risk in the form of non-calcified coronary plaque burden (NCB) by CCTA. We sought to test the relationship between inflammatory monocyte subsets and NCB by CCTA in psoriasis. Methods: Biologic-naïve psoriasis patients (n=81) with moderate-to-severe skin disease were compared with healthy-volunteers (n=14). We determined the frequency of circulating monocyte subsets defined as classical (CD14++CD16-), intermediate (CD14++CD16+), and non-classical (CD14loCD16++) monocytes. NCB was phenotyped by CCTA using QAngio CT (Medis). Results: Consecutive psoriasis patients (n=81) were middle-aged, predominantly male, with low CV risk by Framingham risk score and moderate-to-severe skin disease severity (Table 1). Psoriasis patients exhibited increased circulating classical monocyte frequency (PSO vs controls: 71.7 (48.9-83.5) vs. 46.0 (32.2-65.2), p=0.02) and had elevated NCB (PSO vs controls: 1.09 ± 0.43 vs. 0.89 ± 0.39, p=0.002) when compared to healthy-volunteers. Furthermore, this difference in NCB persisted even when adjusted for age, sex and waist-to-hip ratio (ß=0.14, p=0.029). Finally, classical monocyte frequency associated with NCB even in adjusted models in psoriasis (ß=0.15, p=0.01). Conclusion: Classical monocyte frequency was increased in psoriasis and associated with NCB by CCTA beyond traditional risk factors. Our findings further support the pro-inflammatory role of classical monocytes in subclinical atherosclerosis in psoriasis and should be tested in larger studies.

Scientific Focus Area: Immunology

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