Cardiovascular Morbidity in Psoriatic Arthritis: What Is the Effect of Inflammation?
Bibliographic record
Abstract
The association between chronic inflammatory arthritis and cardiovascular (CV) morbidity is well established. Patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis are at increased risk for CV morbidity and mortality1. This risk remains high even after accounting for traditional CV risk factors, which highlights the potential role of chronic inflammation and its interaction with conventional risk factors in promoting atherosclerosis. However, much of the knowledge about CV comorbidities in rheumatic patients, its epidemiology, and its underlying mechanisms comes from studies in patients with RA, while such data are limited in PsA. While some overlap can be found between PsA and RA in clinical features, treatment modalities, and underlying proinflammatory mechanisms, major differences exist between these 2 conditions. For example, PsA differs from RA in its demographics, the characteristics and extent of involvement of extraarticular tissues, the lack of autoantibodies, and the primary role that the interleukin (IL)-17/IL-23 pathway plays in disease evolution. These differences may affect CV risk and support the need for specific studies evaluating CV morbidity in patients with PsA. The study by Agca, et al 2 in the current issue of The Journal assesses the effect of etanercept (ETN), an inhibitor of tumor necrosis factor-α (TNF-α), on lipid levels and other CV risk factors in patients with PsA and thus addresses some of these gaps in knowledge. What do we know about CV morbidity in PsA? It is accepted that the prevalence of CV disease (CVD) is elevated in patients with psoriasis and PsA compared with the general population. A recent metaanalysis found that CV morbidity is increased by 43% in patients with PsA3. The prevalence of established CV risk factors, such as metabolic syndrome, diabetes, hypertension, and dyslipidemia, is also elevated in psoriatic patients4, which raises the … Address correspondence to Dr. L. Eder, Toronto Western Hospital, Centre for Prognosis Studies in The Rheumatic Diseases, 399 Bathurst St., Toronto, Ontario M5T 2S8, Canada. E-mail: leder{at}uhnresearch.ca, benlihi{at}gmail.com
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".