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Observational Study
. 2025 Jun;23(2):e70136.
doi: 10.1002/msc.70136.

Relationship Between Nail Psoriasis Severity Index and Cardiovascular Risk Assessed by 10 Cardiovascular Risk Calculators

Maria F Elizondo-Benitez  1 , Andrea L Guajardo-Aldaco  1 , Fernanda M Garcia-Garcia  2 , Dionicio A Galarza-Delgado  2 , Jose R Azpiri-Lopez  3 , Rosa I Arvizu-Rivera  2 , Jesus A Cardenas-de la Garza  2 , Valeria Gonzalez-Gonzalez  1 , Iris J Colunga-Pedraza  2
Affiliations
Observational Study

Relationship Between Nail Psoriasis Severity Index and Cardiovascular Risk Assessed by 10 Cardiovascular Risk Calculators

Maria F Elizondo-Benitez et al. Musculoskeletal Care. 2025 Jun.

Abstract

Objective: To determine the relationship between Nail Psoriasis Severity Index (NAPSI) and cardiovascular risk (CVR) assessed by 10 CVR calculators.

Methods: Cross-sectional, observational, and comparative study of psoriatic arthritis (PsA) patients aged 30-75, classified according to established diagnostic criteria. The NAPSI was assessed, classifying patients into two groups: with (≥ 1) and without (< 1) nail involvement. The CVR was evaluated through: Framingham (FRS) lipids and body mass index (BMI), American College of Cardiology/American Heart Association- Atherosclerotic Cardiovascular Disease 2013 (ACC/AHA ASCVD 2013), Systematic Coronary Risk Evaluation (SCORE), SCORE 2, SCORE-Older Persons (OP), QRISK3, Reynolds Risk Score (RRS), Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) atherosclerotic cardiovascular disease (ASCVD) and PREVENT Heart Failure (HF) calculator. Group distribution was assessed using the Kolmogorov-Smirnov test. Comparisons were conducted accordingly with Chi-Squared, T-Student, U-Mann-Whitney, and Kruskal-Wallis tests. Correlations were performed using Spearman's rho. Statistical significance was set at p ≤ 0.05.

Results: Seventy-one patients with PsA were included, 31 with nail involvement and 40 without. CVR score was higher in PsA patients with nail involvement using SCORE (2.0 (1.0-3.7) versus 1.0 (0.0-2.0), p = 0.02). Regarding CVR, positive correlations were found between NAPSI and the following calculators: ACC/AHA ASCVD 2013 (Spearman's rho = 0.202, p = 0.045), FRS BMI (Spearman's rho = 0.229, p = 0.027), SCORE (Spearman's rho = 0.344, p = 0.002), PREVENT ASCVD (Spearman's rho = 0.198, p = 0.049), and PREVENT HF (Spearman's rho = 0.291, p = 0.007).

Conclusions: A NAPSI ≥ 1 score is related to higher CVR assessed through SCORE and positively correlates with ACC/AHA, PREVENT TM ASCVD, and PREVENT HF.

Keywords: cardiovascular diseases; cardiovascular risk assessment; nail psoriasis; psoriatic arthritis.

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