Alexander Egeberg1, Louise E Bruun2, Lotus Mallbris3, Gunnar H Gislason4, Lone Skov5, Jashin J Wu6, Peter R Hansen2. 1. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: alexander.egeberg@gmail.com. 2. Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 3. Unit of Dermatology and Venereology, Karolinska Institutet, Stockholm, Sweden. 4. Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; The Danish Heart Foundation, Copenhagen, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 5. Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 6. Department of Dermatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California.
Abstract
BACKGROUND: Patients with psoriasis may have increased risk of major adverse cardiovascular (CV) events (MACE), and a family history of CV disease (CVD) is an independent risk factor for MACE. OBJECTIVE: We investigated the risk of first-time MACE in patients with psoriasis with or without a family history of CVD. METHODS: Between January 1, 1997, and December 31, 2011, we identified 2,722,375 individuals, including 25,774 and 4504 patients with mild and severe psoriasis, through administrative registers. Incidence rate ratios were estimated by Poisson regression. RESULTS: Mean baseline age was 26.6 (SD 8.6) years. A family history of CVD was found among 16,080 (62.4%) and 3009 (66.8%) patients with mild and severe psoriasis, respectively. In patients with psoriasis and a family history of CVD, the adjusted incidence rate ratios (95% CI) of MACE were 1.28 (1.12-1.46) and 1.62 (1.14-2.30) for mild and severe disease, respectively. In patients with psoriasis but without a family history of CVD, there was no increased risk of MACE. LIMITATIONS: Results may not apply to late-onset psoriasis. CONCLUSIONS: A family history of CVD predicted the risk of first-time MACE in young adults with psoriasis. The findings call for increased focus on a family history of CVD in CV risk assessment of patients with psoriasis.
BACKGROUND:Patients with psoriasis may have increased risk of major adverse cardiovascular (CV) events (MACE), and a family history of CV disease (CVD) is an independent risk factor for MACE. OBJECTIVE: We investigated the risk of first-time MACE in patients with psoriasis with or without a family history of CVD. METHODS: Between January 1, 1997, and December 31, 2011, we identified 2,722,375 individuals, including 25,774 and 4504 patients with mild and severe psoriasis, through administrative registers. Incidence rate ratios were estimated by Poisson regression. RESULTS: Mean baseline age was 26.6 (SD 8.6) years. A family history of CVD was found among 16,080 (62.4%) and 3009 (66.8%) patients with mild and severe psoriasis, respectively. In patients with psoriasis and a family history of CVD, the adjusted incidence rate ratios (95% CI) of MACE were 1.28 (1.12-1.46) and 1.62 (1.14-2.30) for mild and severe disease, respectively. In patients with psoriasis but without a family history of CVD, there was no increased risk of MACE. LIMITATIONS: Results may not apply to late-onset psoriasis. CONCLUSIONS: A family history of CVD predicted the risk of first-time MACE in young adults with psoriasis. The findings call for increased focus on a family history of CVD in CV risk assessment of patients with psoriasis.
Authors: Michael S Garshick; Georgeta Vaidean; Cyrus A Nikain; Yu Chen; Nathaniel R Smilowitz; Jeffrey S Berger Journal: Int J Womens Dermatol Date: 2019-05-18