OBJECTIVE: The magnitude of the cardiovascular risk from psoriasis and psoriatic arthritis is debated. We therefore investigated the psoriasis-related risk of adverse cardiovascular events and mortality. DESIGN, SETTING AND SUBJECTS: We conducted a cohort study of the entire Danish population aged ≥18 years followed from 1997 to 2006 by individual-level linkage of nationwide registers. Psoriasis was defined by prescription claims and classified as severe if patients received hospital-based treatment. Time-dependent Poisson regression models were applied to assess cardiovascular risk in patients with psoriasis and psoriatic arthritis. MAIN OUTCOME MEASURES: All-cause mortality, cardiovascular mortality and hospitalizations for myocardial infarction (MI), stroke and coronary revascularization were recorded. RESULTS: A total of 34 371 patients with mild psoriasis and 2621 with severe psoriasis, including 607 with psoriatic arthritis, were identified and compared with 4 003 265 controls. The event rates and rate ratios (RRs) of all-cause mortality, cardiovascular death, MI, coronary revascularization, stroke and a composite of MI, stroke and cardiovascular death were increased in patients with psoriasis. The rate ratio increased with disease severity and decreased with age of onset. The overall RRs for the composite endpoint were 1.20 (95% confidence interval [CI] 1.14-1.25) and 1.58 (95% CI 1.36-1.82) for mild and severe psoriasis, respectively. The corresponding RRs for cardiovascular death were 1.14 (95% CI 1.06-1.22) and 1.57 (95% CI1.27-1.94). The risk was similar in patients with severe skin affection alone and those with psoriatic arthritis. CONCLUSIONS: Psoriasis is associated with increased risk of adverse cardiovascular events and all-cause mortality. Young age, severe skin affection and/or psoriatic arthritis carry the most risk. Patients with psoriasis may be candidates for early cardiovascular risk factor modification.
OBJECTIVE: The magnitude of the cardiovascular risk from psoriasis and psoriatic arthritis is debated. We therefore investigated the psoriasis-related risk of adverse cardiovascular events and mortality. DESIGN, SETTING AND SUBJECTS: We conducted a cohort study of the entire Danish population aged ≥18 years followed from 1997 to 2006 by individual-level linkage of nationwide registers. Psoriasis was defined by prescription claims and classified as severe if patients received hospital-based treatment. Time-dependent Poisson regression models were applied to assess cardiovascular risk in patients with psoriasis and psoriatic arthritis. MAIN OUTCOME MEASURES: All-cause mortality, cardiovascular mortality and hospitalizations for myocardial infarction (MI), stroke and coronary revascularization were recorded. RESULTS: A total of 34 371 patients with mild psoriasis and 2621 with severe psoriasis, including 607 with psoriatic arthritis, were identified and compared with 4 003 265 controls. The event rates and rate ratios (RRs) of all-cause mortality, cardiovascular death, MI, coronary revascularization, stroke and a composite of MI, stroke and cardiovascular death were increased in patients with psoriasis. The rate ratio increased with disease severity and decreased with age of onset. The overall RRs for the composite endpoint were 1.20 (95% confidence interval [CI] 1.14-1.25) and 1.58 (95% CI 1.36-1.82) for mild and severe psoriasis, respectively. The corresponding RRs for cardiovascular death were 1.14 (95% CI 1.06-1.22) and 1.57 (95% CI1.27-1.94). The risk was similar in patients with severe skin affection alone and those with psoriatic arthritis. CONCLUSIONS:Psoriasis is associated with increased risk of adverse cardiovascular events and all-cause mortality. Young age, severe skin affection and/or psoriatic arthritis carry the most risk. Patients with psoriasis may be candidates for early cardiovascular risk factor modification.
Authors: Michael S Garshick; Tessa J Barrett; Todd Wechter; Sarah Azarchi; Jose U Scher; Andrea Neimann; Stuart Katz; Judilyn Fuentes-Duculan; Maria V Cannizzaro; Sanja Jelic; Edward A Fisher; James G Krueger; Jeffrey S Berger Journal: Arterioscler Thromb Vasc Biol Date: 2019-04 Impact factor: 8.311
Authors: Monalyn Labitigan; Asena Bahče-Altuntas; Joel M Kremer; George Reed; Jeff D Greenberg; Nicole Jordan; Chaim Putterman; Anna Broder Journal: Arthritis Care Res (Hoboken) Date: 2014-04 Impact factor: 4.794
Authors: Howa Yeung; Joy Wan; Abby S Van Voorhees; Kristina Callis Duffin; Gerald G Krueger; Robert E Kalb; Jamie D Weisman; Brian R Sperber; Bruce A Brod; Stephen M Schleicher; Bruce F Bebo; Daniel B Shin; Andrea B Troxel; Joel M Gelfand Journal: J Am Acad Dermatol Date: 2012-07-28 Impact factor: 11.527
Authors: Aditya A Joshi; Joseph B Lerman; Tsion M Aberra; Mehdi Afshar; Heather L Teague; Justin A Rodante; Parasuram Krishnamoorthy; Qimin Ng; Tarek Z Aridi; Taufiq Salahuddin; Balaji Natarajan; Benjamin N Lockshin; Mark A Ahlman; Marcus Y Chen; Daniel J Rader; Muredach P Reilly; Alan T Remaley; David A Bluemke; Martin P Playford; Joel M Gelfand; Nehal N Mehta Journal: Circ Res Date: 2016-09-21 Impact factor: 17.367