Dilated Psoriatic Coronopathy: A Novel Association

Yuvraj Singh Chowdhury¹, Rishard Abdul¹, Pramod Theetha Kariyanna¹, Apoorva Jayarangaiah², Mrinali Shetty³, Clara Wilson¹, Naureen Kabani¹, Jonathan D. Marmur¹, Alan Feit¹, Moro O. Salifu¹ and Isabel M. McFarlane^1,

¹Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, N.Y, USA - 11203

²Department of Internal Medicine, Albert Einstein College of Medicine, NYC + HHC Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY, USA- 10461

³Division of Cardiovascular Disease and Department of Internal Medicine, University of Chicago- Northshore University Health Systems, Chicago, IL, USA - 60631

Cite this paper

Yuvraj Singh Chowdhury, Rishard Abdul, Pramod Theetha Kariyanna, Apoorva Jayarangaiah, Mrinali Shetty, Clara Wilson, Naureen Kabani, Jonathan D. Marmur, Alan Feit, Moro O. Salifu and Isabel M. McFarlane. Dilated Psoriatic Coronopathy: A Novel Association. American Journal of Medical Case Reports. 2020; 8(9):277-280. doi: 10.12691/AJMCR-8-9-6

Abstract

Coronary artery ectasia (CAE) is defined by the Coronary Artery Surgery Study (CASS) registry as the aneurysmal dilatation 1.5 times the diameter of a coronary artery compared to the adjacent normal coronary artery. CAE is reported with a prevalence of 1.2% - 4.9%. Most CAEs are attributed to atherosclerosis or post-percutaneous coronary intervention (PCI) vessel injury. Vasculitides and infection are uncommon etiologies. A review of 59,423 patients from the Danish registry demonstrated a 3-fold increase in the prevalence of abdominal aortic aneurysms in patients with concomitant severe psoriasis. We present a case of a 64-year-old male with severe plaque psoriasis complaining of substernal chest pain whose coronary angiography demonstrated CAE of the left anterior descending and circumflex arteries. Due to its pro-inflammatory state, psoriasis is associated with various systemic manifestations including cardiac and vascular complications. With possibly a similar underlying pathophysiological mechanism, we describe to the best of our knowledge the first case of CAE in a patient with severe psoriasis.

Keywords

coronary artery ectasia, psoriasis, inflammation, atherosclerosis, abdominal anerurysms

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Swaye, P.S., et al., Aneurysmal coronary artery disease. Circulation, 1983. 67(1): p. 134-8.
[2]	Hartnell, G.G., B.M. Parnell, and R.B. Pridie, Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients. Br Heart J, 1985. 54(4): p. 392-5.
[3]	Markis, J.E., et al., Clinical significance of coronary arterial ectasia. Am J Cardiol, 1976. 37(2): p. 217-22.
[4]	Kawsara, A., et al., Management of Coronary Artery Aneurysms. JACC Cardiovasc Interv, 2018. 11(13): p. 1211-1223.
[5]	Diaz-Zamudio, M., et al., Coronary artery aneurysms and ectasia: role of coronary CT angiography. Radiographics, 2009. 29(7): p. 1939-54.
[6]	Roberts, W.C., Natural history, clinical consequences, and morphologic features of coronary arterial aneurysms in adults. Am J Cardiol, 2011. 108(6): p. 814-21.
[7]	Devabhaktuni, S., et al., Coronary Artery Ectasia-A Review of Current Literature. Current cardiology reviews, 2016. 12(4): p. 318-323.
[8]	Chiu, H.-Y., et al., Increased risk of aortic aneurysm (AA) in relation to the severity of psoriasis: A national population-based matched-cohort study. Journal of the American Academy of Dermatology, 2016. 75(4): p. 747-754.
[9]	Di Meglio, P., F. Villanova, and F.O. Nestle, Psoriasis. Cold Spring Harbor perspectives in medicine, 2014. 4(8): p. a015354.
[10]	Rachakonda, T.D., C.W. Schupp, and A.W. Armstrong, Psoriasis prevalence among adults in the United States. J Am Acad Dermatol, 2014. 70(3): p. 512-6.
[11]	Prodanovich, S., et al., Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol, 2009. 145(6): p. 700-3.
[12]	Salihbegovic, E.M., et al., Psoriasis and high blood pressure. Med Arch, 2015. 69(1): p. 13-5.
[13]	Holm, J.G. and S.F. Thomsen, Type 2 diabetes and psoriasis: links and risks. Psoriasis (Auckland, N.Z.), 2019. 9: p. 1-6.
[14]	Jensen, P. and L. Skov, Psoriasis and Obesity. Dermatology, 2016. 232(6): p. 633-639.
[15]	Khalid, U., et al., Nationwide Study on the Risk of Abdominal Aortic Aneurysms in Patients With Psoriasis. Arterioscler Thromb Vasc Biol, 2016. 36(5): p. 1043-8.
[16]	Ghazizadeh, R., et al., Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci, 2010. 7(5): p. 284-9.
[17]	Shlyankevich, J., et al., Accumulating evidence for the association and shared pathogenic mechanisms between psoriasis and cardiovascular-related comorbidities. Am J Med, 2014. 127(12): p. 1148-53.
[18]	Johnston, A., et al., Susceptibility-associated genetic variation at IL12B enhances Th1 polarization in psoriasis. Human molecular genetics, 2013. 22(9): p. 1807-1815.
[19]	Jindal, S. and N. Jindal, Psoriasis and Cardiovascular Diseases: A Literature Review to Determine the Causal Relationship. Cureus, 2018. 10(2): p. e2195-e2195.