Premature Coronary Artery Disease (CAD) in Severe Psoriasis
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Purpose
The purpose of this study is to compare the prevalence and severity of CAD (coronary artery disease) in patients with and without severe psoriasis, otherwise matched for cardiovascular risk factors.
| Condition | Intervention | Phase |
|---|---|---|
|
Psoriasis Coronary Artery Disease |
Procedure: CCTA Scan (Coronary CT Angiogram) |
Phase 1 |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control Time Perspective: Prospective |
| Official Title: | Premature Coronary Artery Disease (CAD) in Severe Psoriasis |
- To establish the relationship between psoriasis and coronary disease [ Time Frame: 1 year ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 120 |
| Study Start Date: | November 2009 |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Subjects with severe psoriasis
Subjects 18 to 55 with severe psoriasis
|
Procedure: CCTA Scan (Coronary CT Angiogram)
CCTA scan will be performed to study and evaluate the prevalence and severity of coronary artery disease (CAD).
|
|
Subjects without psoriasis
Subjects 18 to 55 who do not have psoriasis or rheumatologic conditions, including rheumatoid arthritis and systemic lupus erythematosus.
|
Procedure: CCTA Scan (Coronary CT Angiogram)
CCTA scan will be performed to study and evaluate the prevalence and severity of coronary artery disease (CAD).
|
Detailed Description:
To establish the relationship between psoriasis and coronary disease by comparing the prevalence and severity of CAD (coronary artery disease) in patients with and without severe psoriasis, otherwise matched for cardiovascular risk factors, as determined by CT coronary calcium scoring and Coronary CT angiography.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Probability Sample |
Subjects with severe psoriasis will be selected prospectively from the clinics of the University of Michigan, Dept. of Dermatology.
The comparison group (subjects without psoriasis) will be targeted in the Dermatology clinic by screening for matching variables before enrollment. This group will be matched by age and gender to the psoriasis population, and on Framingham risk score.
Inclusion Criteria:
- Patients with severe psoriasis as determined by more than two episodes of systemic or inpatient treatment and 10% or more body surface area involvement.
- Male or female ages 18 to 55 (because CAD risk has been shown to be greatest in younger psoriasis patients in earlier studies, this pilot study will focus on young individuals).
- Able to give informed consent
Exclusion Criteria:
Prior diagnosis of CAD or heart disease based upon one or more of the following:
- coronary arteriography
- percutaneous coronary intervention
- cardiac surgery including bypass graft surgery
- valve surgery
- congenital heart disease repair
- stress ECG or imaging
- myocardial infarction
- angina or unstable angina
- congestive heart failure
- cardiomyopathy
- History of anti-oxidants such as fish oil or biologic therapy Tumor Necrosis Factor alpha inhibitors (such as etanercept, adalimumab, or infliximab). A recent review by Sattar et al [22] has shown preliminary evidence that TNF blockade can modulate nontraditional cardiovascular risk factors such as C-reactive protein(CRP), Interleukin-6(IL-6), Apolipoprotein AI(ApoAI), Lipoprotein(a)(Lp[a]), Sex Hormone Binding Globulin (SHBG), and homocysteine to exert a possible vascular and metabolic protective effect.
- Pustular and erythrogenic psoriasis
- Unable to give informed consent
Contraindications to coronary CT, including:
- Irregular heart rate, such as multiple PVCs, atrial fibrillation
- Active heart failure
- Serum creatinine > 1.5mg/dl
- Weight > 320 lbs (due to degradation in CT image quality by image noise)
- History of severe allergy to intravenous contrast media
- High irregular heart rate with contraindications to beta-blockers
- Pregnant
Contacts and Locations| Contact: Prachi P Agarwal, M.D. | 734-936-4366 | prachi@umich.edu |
| United States, Michigan | |
| University of Michigan Hospital | Recruiting |
| Ann Arbor, Michigan, United States, 48109 | |
| Contact: Prachi P Agarwal, M.D. 734-936-4366 prachi@umich.edu | |
| Principal Investigator: | Prachi P Agarwal, M.D. | University of Michigan Hospital |
More Information
No publications provided
| Responsible Party: | Prachi Pragya Agarwal, University of Michigan |
| ClinicalTrials.gov Identifier: | NCT00893126 History of Changes |
| Other Study ID Numbers: | HUM00020514 |
| Study First Received: | May 1, 2009 |
| Last Updated: | August 3, 2011 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Michigan:
|
psoriasis coronary arteriosclerosis coronary events rheumatoid arthritis arthritis |
Additional relevant MeSH terms:
|
Coronary Artery Disease Myocardial Ischemia Coronary Disease Psoriasis Heart Diseases Cardiovascular Diseases |
Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Skin Diseases, Papulosquamous Skin Diseases |
ClinicalTrials.gov processed this record on June 13, 2013