Attributable Risk Estimate of Severe Psoriasis on Major Cardiovascular Events

• Published in: The American journal of medicine Vol. 124; no. 8; pp. 775.e1 - 775.e6
• Main Authors: Mehta, Nehal N., MD, MSCE, FAHA, Yu, YiDing, BA, Pinnelas, Rebecca, BS, Krishnamoorthy, Parasuram, MD, Shin, Daniel B., BA, Troxel, Andrea B., ScD, Gelfand, Joel M., MD, MSCE
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2011
• Subjects: Adult; Aged; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cohort Studies; Confounding Factors, Epidemiologic; Female; Humans; Incidence; Inflammation; Inflammation - complications; Internal Medicine; Major adverse cardiac events; Male; Middle Aged; Psoriasis; Psoriasis - complications; Psoriasis - epidemiology; Research Design; Risk Assessment; Risk Factors; Severity of Illness Index; United States - epidemiology; United States; Major adverse cardiac events; Inflammation; Psoriasis; Risk factors
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2011.03.028

Abstract Background Recent studies suggest that psoriasis, particularly if severe, may be a risk factor for major adverse cardiac events, such as myocardial infarction, stroke, and mortality from cardiovascular disease. We compared the risk of major adverse cardiac events between patients with psoriasis and the general population and estimated the attributable risk of severe psoriasis. Methods We performed a cohort study in the General Practice Research Database. Severe psoriasis was defined as receiving a psoriasis diagnosis and systemic therapy (N = 3603). Up to 4 patients without psoriasis were selected from the same practices and start dates for each patient with psoriasis (N = 14,330). Results Severe psoriasis was a risk factor for major adverse cardiac events (hazard ratio 1.53; 95% confidence interval, 1.26-1.85) after adjusting for age, gender, diabetes, hypertension, tobacco use, and hyperlipidemia. After fully adjusted analysis, severe psoriasis conferred an additional 6.2% absolute risk of 10-year major adverse cardiac events. Conclusion Severe psoriasis confers an additional 6.2% absolute risk of a 10-year rate of major adverse cardiac events compared with the general population. This potentially has important therapeutic implications for cardiovascular risk stratification and prevention in patients with severe psoriasis. Future prospective studies are needed to validate these findings.