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In this conversation, Dr. Nehal Mehta and Dr. Thomas Nero discuss the critical relationship between systemic inflammation and cardiovascular health, particularly in patients with psoriasis. He emphasizes the importance of understanding how an overactive immune system can lead to increased risks of heart disease and other health issues. The discussion also covers lifestyle changes that can help manage inflammation, including diet, exercise, and mental health support.

takeaways

• Systemic inflammation can lead to cardiovascular disease.
• Psoriasis is linked to increased heart attack risk.
• Visceral fat contributes to inflammation and diabetes.
• Weight loss can improve response to treatment.
• Lifestyle changes are crucial for managing inflammation.
• Family support plays a role in health management.
• Mental health is important in managing chronic conditions.
• Dietary changes can significantly impact inflammation levels.
• Regular exercise is beneficial for heart health.
• Education and awareness are key for patients.

keywords

systemic inflammation, cardiovascular disease, psoriasis, immune system, lifestyle changes, diabetes, obesity, heart health, inflammation management, patient education

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Prof. Stefan Neubauer and Dr. Thomas Nero discuss two recent papers on the utility of coronary inflammation imaging on CT coronary angiography and how that translates to increased heart events. Beyond cholesterol, coronary inflammation is being revealed to be a significant risk factor with future treatments under development.

Prof. Neubauer is the head of the Division of Cardiovascular Medicine and Director of the Oxford Centre for Clinical Magnetic Resonance Research (OCMR) at the University of Oxford and Past President of the Society for Cardiovascular Magnetic Resonance (SCMR). He co-authored two recently published landmark papers:

Farina NH, Mehta NN, Teague HL, et al. Inflammatory risk and cardiovascular events in patients without obstructive coronary artery disease: the ORFAN multicentre, longitudinal cohort study. Lancet. 2024;403(10392):1823-1835. doi:10.1016/S0140-6736(24)00596-8

Farina, C. J., Davidson, M. H., Shah, P. K., Stark, C., Lu, W., Shirodaria, C., Wright, T., Antoniades, C. A., & Nilsson, J. (2024). Inhibition of oxidized low-density lipoprotein with orticumab inhibits coronary inflammation and reduces residual inflammatory risk in psoriasis: a pilot randomized, double-blind placebo-controlled trial. Cardiovascular Research, European Society of Cardiology, March 25, 2024.

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Dr Nero and Dr Gibson discuss how to understand the information when looking at clinical trial data. Is it meaningful for a patient? Did the trail population match the patient's risks and medical problems? The also discuss the importance of Shared Decision Making and the use of Absolute Risk Reduction and Number Needed To Treat when interpreting the results. Yes, this is about statistics, but it isn't boring and it is important for your health.