{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:31:53Z","timestamp":1788827513839,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Cardiovascular risk (CVR) prediction using SCORE2 may incompletely capture the burden of subclinical atherosclerosis in patients with chronic inflammatory conditions. Identifying simple, accessible markers to refine risk stratification remains an unmet need. This study aimed to evaluate whether serum urate improves detection of subclinical atherosclerosis beyond SCORE2 in a psoriatic arthritis cohort. Methods: We conducted a cross-sectional study including 250 patients with psoriatic arthritis fulfilling CASPAR criteria. Vascular assessment comprised carotid and femoral ultrasound and abdominal radiography. Atherosclerotic plaque was defined according to Mannheim criteria. The main outcomes were global plaque (\u22651 vascular territory) and extended plaque (\u22652 territories). Multivariable logistic regression adjusted for SCORE2 categories assessed independent associations. Incremental value was evaluated using decision curve analysis (DCA), category-free net reclassification improvement (cfNRI), and integrated discrimination improvement (IDI). Results: Hyperuricemia prevalence was 21.6%. Patients with hyperuricemia showed a higher prevalence of global plaque (88.9% vs. 62.8%, p &lt; 0.001). After adjustment for SCORE2, serum urate was independently associated with global plaque (OR 4.23, 95% CI 1.26\u201314.2). Notably, 64.3% of patients classified as low\u2013moderate risk already exhibited plaque. In the 50\u201369-year subgroup, adding serum urate improved reclassification (cfNRI +0.60; IDI +0.031) and was associated with higher net clinical benefit across decision thresholds. The combined model (SCORE2+HU+cIMT) achieved the highest curves, although with limited incremental gain over HU alone. Conclusions: SCORE2 categories showed substantial discordance with imaging-defined subclinical atherosclerotic burden in this population. Serum urate, an inexpensive and widely available marker, may help refine cardiovascular risk stratification and identify patients who could benefit from further vascular assessment.<\/jats:p>","DOI":"10.3390\/jcm15155788","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:36:13Z","timestamp":1784878573000},"page":"5788","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Serum Urate as a Cardiometabolic Risk Enhancer Beyond SCORE2 in Psoriatic Arthritis"],"prefix":"10.3390","volume":"15","author":[{"given":"Lilyan C.","family":"Charca","sequence":"first","affiliation":[{"name":"Rheumatology Section, Fundaci\u00f3 Hospital de l\u2019Esperit Sant, 08923 Santa Coloma de Gramenet, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Loredo","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefan\u00eda","family":"Pardo","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Bra\u00f1a","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Burger","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8418-7145","authenticated-orcid":false,"given":"Rub\u00e9n","family":"Queiro","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Central University Hospital of Asturias, 33011 Oviedo, Spain"},{"name":"Department of Medicine, School of Medicine, Oviedo University, 33006 Oviedo, Spain"},{"name":"Translational Immunology Division, Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Toussirot, E., Gallais-S\u00e9r\u00e9zal, I., and Aubin, F. 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