Asymptomatic Hyperuricemia and Serum Uric Acid Concentration Correlate with Subclinical Atherosclerosis in Psoriatic Arthritis Patients Without Clinically Evident Cardiovascular Disease1

ObjectiveTo 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.MethodsA 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.ResultsPsA 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).ConclusionsIn PsA patients without clinically evident CV disease there is a correlation between serum uric acid concentration and subclinical atherosclerosis.