Psoriasis and the Risk of Major Cardiovascular Events: Cohort Study Using the Clinical Practice Research Datalink

The association between psoriasis and risk of major cardiovascular (CV) events (myocardial infarction, acute coronary syndrome, unstable angina, and stroke) is unclear. A cohort study with 48,523 patients with psoriasis and 208,187 controls was conducted. During a median follow-up of 5.2 years, 1,25...

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Bibliographic Details
Published in:	Journal of investigative dermatology 2015-09, Vol.135 (9), p.2189-2197
Main Authors:	Parisi, Rosa, Rutter, Martin K., Lunt, Mark, Young, Helen S., Symmons, Deborah P.M., Griffiths, Christopher E.M., Ashcroft, Darren M.
Format:	Article
Language:	eng
Subjects:	Acute Coronary Syndrome - diagnosis Acute Coronary Syndrome - epidemiology Acute Coronary Syndrome - therapy Adult Age Distribution Aged Angina, Unstable - diagnosis Angina, Unstable - epidemiology Angina, Unstable - therapy Cardiovascular Diseases - diagnosis Cardiovascular Diseases - epidemiology Cardiovascular Diseases - therapy Case-Control Studies Comorbidity Confidence Intervals Databases, Factual Female Humans Male Middle Aged Multivariate Analysis Myocardial Infarction - diagnosis Myocardial Infarction - epidemiology Myocardial Infarction - therapy Prevalence Prognosis Proportional Hazards Models Psoriasis - diagnosis Psoriasis - epidemiology Psoriasis - therapy Retrospective Studies Risk Assessment Severity of Illness Index Sex Distribution Stroke - diagnosis Stroke - epidemiology Stroke - therapy Survival Analysis Young Adult
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Summary:	The association between psoriasis and risk of major cardiovascular (CV) events (myocardial infarction, acute coronary syndrome, unstable angina, and stroke) is unclear. A cohort study with 48,523 patients with psoriasis and 208,187 controls was conducted. During a median follow-up of 5.2 years, 1,257 patients with psoriasis (2.59%) had a major CV event, compared with 4,784 controls (2.30%). In the multivariable analysis, inflammatory arthritis hazard ratio (HR) 1.36 (1.18–1.58), diabetes HR 1.18 (1.06–1.31), chronic kidney disease HR 1.18 (1.07–1.31), hypertension HR 1.37 (1.29–1.45), transient ischemic attack HR 2.74 (2.41–3.12), atrial fibrillation HR 1.54 (1.36–1.73), valvular heart disease HR 1.23 (1.05–1.44), thromboembolism 1.32 (1.17–1.49), congestive heart failure HR 1.57 (1.39–1.78), depression HR 1.16 (1.01–1.34), current smoker HR 2.18 (2.03–2.33), age (year) HR 1.07 (1.07–1.07), and male gender HR 1.83 (1.69–1.98) were statistically significant for the risk of major CV events. The age- and gender-adjusted HRs of a major CV event for psoriasis were 1.10 (1.04–1.17) and for severe psoriasis 1.40 (1.07–1.84), whereas the fully adjusted HRs were attenuated to 1.02 (0.95–1.08) and 1.28 (0.96–1.69). In conclusion, neither psoriasis nor severe psoriasis were associated with the short-to-medium term (over 3–5 years) risk of major CV events after adjusting for known cardiovascular disease risk factors.
ISSN:	0022-202X 1523-1747