Patompong Ungprasert1, Narat Srivali2, Wonngarm Kittanamongkolchai3. 1. Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, . 2. Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. 3. Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND AND OBJECTIVES: Patients with psoriasis might have a higher risk of developing atrial fibrillation as a result of chronic inflammation. This study aimed to investigate this association by comprehensively reviewing all available evidence. METHODS: We conducted a systematic review and meta-analysis of cohort studies that reported relative risk, hazard ratio, incidence ratio or standardized incidence ratio with 95% confidence intervals comparing the risk of incident atrial fibrillation in patients with psoriasis versus participants without psoriasis. Both retrospective and prospective cohort studies were eligible. Pooled risk ratio and 95% confidence intervals were calculated using random-effect, generic inverse variance methods of DerSimonian and Laird. RESULTS: Three retrospective studies with 110,568 cases of psoriasis and 5,352,817 participants without psoriasis were included in this meta-analysis. The pooled risk ratio of subsequent development of atrial fibrillation in patients with psoriasis versus participants without psoriasis was 1.21 (95% confidence interval, 1.14-1.29). The statistical heterogeneity was low with an I2 of 29%. LIMITATIONS: Coding-based design of the primary studies that had limited accuracy. CONCLUSIONS: Our meta-analysis demonstrated a statistically significant increase in the risk of incident atrial fibrillation among patients with psoriasis.
BACKGROUND AND OBJECTIVES:Patients with psoriasis might have a higher risk of developing atrial fibrillation as a result of chronic inflammation. This study aimed to investigate this association by comprehensively reviewing all available evidence. METHODS: We conducted a systematic review and meta-analysis of cohort studies that reported relative risk, hazard ratio, incidence ratio or standardized incidence ratio with 95% confidence intervals comparing the risk of incident atrial fibrillation in patients with psoriasis versus participants without psoriasis. Both retrospective and prospective cohort studies were eligible. Pooled risk ratio and 95% confidence intervals were calculated using random-effect, generic inverse variance methods of DerSimonian and Laird. RESULTS: Three retrospective studies with 110,568 cases of psoriasis and 5,352,817 participants without psoriasis were included in this meta-analysis. The pooled risk ratio of subsequent development of atrial fibrillation in patients with psoriasis versus participants without psoriasis was 1.21 (95% confidence interval, 1.14-1.29). The statistical heterogeneity was low with an I2 of 29%. LIMITATIONS: Coding-based design of the primary studies that had limited accuracy. CONCLUSIONS: Our meta-analysis demonstrated a statistically significant increase in the risk of incident atrial fibrillation among patients with psoriasis.