Ari Polachek1, Zahi Touma2, Melanie Anderson3, Lihi Eder4. 1. University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada. 2. University of Toronto, Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada. 3. University Health Network, Toronto, Ontario, Canada. 4. University of Toronto, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To assess the magnitude of risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis (PsA) compared with the general population through a systematic review and meta-analysis of observational studies. METHODS: We searched the Medline, Embase, and Cochrane databases, as well as abstracts archives from rheumatology conferences. Observational studies that included a PsA diagnosis, cardiovascular or cerebrovascular outcomes, and a comparison group of individuals without psoriasis and rheumatic diseases and were case-control, cross-sectional, or cohort studies, were assessed by 2 researchers. We calculated weighted pooled summary estimates of the maximally adjusted effect size estimates for cardiovascular and cerebrovascular diseases using the random-effects model, and tested for heterogeneity using the I2 statistic. RESULTS: Eleven studies, comprising 32,973 patients with PsA, met the inclusion criteria. There was a 43% increased risk of cardiovascular diseases in patients with PsA compared with the general population (pooled odds ratio [OR] 1.43 [95% confidence interval (95% CI) 1.24-1.66]). The risk of incident cardiovascular events was increased by 55% (pooled OR 1.22-1.96). Morbidity risks for myocardial infarction, cerebrovascular diseases, and heart failure were increased by 68%, 22%, and 31%, respectively (pooled OR 1.68 [95% CI 1.31-2.15], pooled OR 1.22 [95% CI 1.05-1.41], and pooled OR 1.31 [95% CI 1.11-1.55], respectively). We identified significant heterogeneity in all main analyses (P < 0.001). CONCLUSION: Cardiovascular and cerebrovascular morbidity are increased by 43% and 22%, respectively, in patients with PsA compared with the general population.
OBJECTIVE: To assess the magnitude of risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis (PsA) compared with the general population through a systematic review and meta-analysis of observational studies. METHODS: We searched the Medline, Embase, and Cochrane databases, as well as abstracts archives from rheumatology conferences. Observational studies that included a PsA diagnosis, cardiovascular or cerebrovascular outcomes, and a comparison group of individuals without psoriasis and rheumatic diseases and were case-control, cross-sectional, or cohort studies, were assessed by 2 researchers. We calculated weighted pooled summary estimates of the maximally adjusted effect size estimates for cardiovascular and cerebrovascular diseases using the random-effects model, and tested for heterogeneity using the I2 statistic. RESULTS: Eleven studies, comprising 32,973 patients with PsA, met the inclusion criteria. There was a 43% increased risk of cardiovascular diseases in patients with PsA compared with the general population (pooled odds ratio [OR] 1.43 [95% confidence interval (95% CI) 1.24-1.66]). The risk of incident cardiovascular events was increased by 55% (pooled OR 1.22-1.96). Morbidity risks for myocardial infarction, cerebrovascular diseases, and heart failure were increased by 68%, 22%, and 31%, respectively (pooled OR 1.68 [95% CI 1.31-2.15], pooled OR 1.22 [95% CI 1.05-1.41], and pooled OR 1.31 [95% CI 1.11-1.55], respectively). We identified significant heterogeneity in all main analyses (P < 0.001). CONCLUSION: Cardiovascular and cerebrovascular morbidity are increased by 43% and 22%, respectively, in patients with PsA compared with the general population.
Authors: Lihi Eder; Paula Harvey; Vinod Chandran; Cheryl F Rosen; Jan Dutz; James T Elder; Proton Rahman; Christopher T Ritchlin; Sherry Rohekar; Richard Hayday; Snezana Barac; Joy Feld; Devy Zisman; Dafna D Gladman Journal: J Rheumatol Date: 2018-02-01 Impact factor: 4.666
Authors: Katelynn M Wilton; Sara J Achenbach; Paras Karmacharya; Floranne C Ernste; Eric L Matteson; Cynthia S Crowson Journal: J Rheumatol Date: 2020-10-15 Impact factor: 5.346
Authors: Steven H Lam; Ho So; Isaac T Cheng; Edmund K Li; Priscilla Wong; Tena K Li; Alex Pui-Wai Lee; Lai-Shan Tam Journal: Ther Adv Musculoskelet Dis Date: 2021-06-30 Impact factor: 5.346
Authors: Thao H P Nguyen; Morten Wang Fagerland; Gia Deyab; Gunnbjørg Hjeltnes; Ivana Hollan; Mark W Feinberg; Gro Ø Eilertsen; Knut Mikkelsen; Stefan Agewall Journal: PLoS One Date: 2021-06-25 Impact factor: 3.240