Serum Calprotectin Level is Independently Associated with Carotid Plaque Presence in Patients with Psoriatic Arthritis

Background: Whether calprotectin could play a role in augmenting cardiovascular (CV) risk in patients with psoriatic arthritis (PsA) remains uncertain. The aim of this study is to elucidate the association between serum calprotectin and subclinical atherosclerosis and arterial stiffness in patient with PsA. Method: Seventy-eight PsA patients (age: 52±10 years, 41 [52.6%] male) without CV disease were recruited into this cross-sectional study. Carotid intima-media thickness (cIMT) and the presence of plaque were determined by high-resolution ultrasound. Arterial stiffness was measured by brachial-ankle PWV (baPWV) and augmentation index (AIx) Calprotectin levels in serum were quantified by enzyme-linked immunosorbent assay. Results: 29/78 (37.2%) of patient had carotid plaque (CP+ group). Serum calprotectin levels were significantly higher in the CP+ group (CP- group: 564.6 [329.3-910.5] ng/ml; CP+ group: 721.3 [329.3-910.5] ng/ml, P=0.005). Serum calprotectin level correlated with C-reactive protein (CRP) (r=0.244, P =0.033) and PsA disease duration (r=0.245, P =0.030). Using multivariate logistic regression analysis, the levels of Ln-calprotectin were significantly associated with the presence of CP (OR: 3.19, 95% confidence interval [CI]: [1.22, 8.38]; P=0.018), and mean cIMT (β: 0.35, 95% CI [0.02, 0.68]; P=0.038) after adjusting for baseline covariates. The optimal cut-offs for discriminating patients with and without CP were calprotectin >569ng/ml (AUC: 0.688; sensitivity: 79%; specificity: 51%; P=0.006) and FRS >9% (AUC: 0.645; sensitivity: 62%; specificity: 67%; P=0.033). Conclusion: Serum calprotectin level may be a good biomarker for CV risk stratification in PsA. Further studies are required to confirm whether this pathway is associated with CV events in PsA.