USF-LVHN SELECT

A practical inflammatory blood-cell marker for cardiovascular risk stratification in psoriasis: Development of the Platelet-Leukocyte Adjusted Cardiovascular (PLAC) score.

Publication/Presentation Date

1-1-2026

Abstract

BACKGROUND: Psoriasis is an inflammatory disease associated with atherosclerotic cardiovascular disease (ASCVD). Although blood-cell markers predict ASCVD in the general population, the utility of these markers in cardiovascular risk stratification in psoriasis remains unclear given heightened inflammatory burdens among these patients.

OBJECTIVES: We aimed to develop a composite ASCVD risk score for psoriasis and evaluate its performance by integrating a novel inflammatory blood-cell marker with traditional cardiovascular risk factors.

METHODS: We conducted a retrospective cohort study using All of Us (enrollment:May 2018-October 2023). ASCVD included acute coronary syndrome, cerebrovascular accident, or coronary artery disease. Independent predictors of ASCVD in Cox regression informed the Platelet-Leukocyte Adjusted Cardiovascular (PLAC) score, incorporating the Neutrophil-to-Platelet-to-Monocyte Ratio (NuPMoR=neutrophils/[platelets x monocytes]), age ≥ 65, male sex, hypertension, and diabetes.

RESULTS: Among 1,572 psoriasis patients (median follow-up 7.2 years), the PLAC score (AUC 0.69, 95% CI 0.65-0.74), which incorporates NuPMoR, stratified patients into low-, medium-, and high-risk groups with corresponding 10-year ASCVD incidences of 4.9%, 11.8%, and 39.9%. Compared with the low-risk group, medium- (HR 2.27, 95% CI 1.53-3.39) and high-risk (HR 6.40, 95% CI 3.97-10.33) groups had significantly higher ASCVD hazard. The PLAC score demonstrated similar or numerically higher discrimination than the Framingham and PCE models in limited samples.

CONCLUSIONS: The PLAC score is a practical, psoriasis-specific ASCVD risk tool that integrates a novel inflammatory marker with traditional risk factors. It enables clinically meaningful ASCVD risk stratification using routine laboratory values in a high-risk population and may help identify psoriasis patients warranting closer cardiovascular monitoring.

Volume

21

Issue

7

First Page

0353475

Last Page

0353475

ISSN

1932-6203

Disciplines

Medical Education | Medicine and Health Sciences

PubMedID

42424368

Department(s)

USF-LVHN SELECT Program, USF-LVHN SELECT Program Students

Document Type

Article

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