Psoriasis alone is not linked to an increased risk of major cardiovascular (CV) events after adjusting for other risk factors, according to findings published recently in the Journal of Investigative Dermatology.
Previous studies that evaluated the association between psoriasis and risk of major CV events, including myocardial infarction, acute coronary syndrome, unstable angina, and stroke, have produced unclear results.
Rosa Parisi, PhD, from the University of Manchester, and colleagues on behalf of the Identification and Management of Psoriasis Associated ComorbidiTy (IMPACT) project team conducted a cohort study that included 48,523 patients with psoriasis and 208,187 patients without psoriasis who served as the control group.
Patients in the study were followed for a median of 5.2 years, and the rate of major CV events that occurred among the 1,257 patients with psoriasis compared with the 4,784 patients in the control group was not statistically significant (2.59% vs. 2.30%, respectively).
Results of the multivariable analysis revealed that 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.
After adjusting for age and gender, the HR of a major CV event for psoriasis was 1.10 and 1.40 for severe psoriasis. The fully adjusted HRs were attenuated to 1.02 and 1.28, which led the authors to conclude that “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.”
- Parisi R. J Invest Dermatol. 2015 Mar 5, 2015; doi: 10.1038/jid.2015.87. [Epub ahead of print].