Premium
Risk and predictors of cardiovascular disease in psoriasis: a population‐based study
Author(s) -
MaraditKremers Hilal,
Dierkhising Ross A.,
Crowson Cynthia S.,
Icen Murat,
Ernste Floranne C.,
McEvoy Marian T.
Publication year - 2013
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/j.1365-4632.2011.05430.x
Subject(s) - medicine , psoriasis , hazard ratio , myocardial infarction , framingham risk score , population , cohort , cohort study , incidence (geometry) , cardiology , framingham heart study , heart failure , confidence interval , disease , dermatology , physics , environmental health , optics
Background Emerging evidence suggests that severe psoriasis is associated with increased risk of cardiovascular disease. The goal of this study was to examine the risk and predictors of clinical cardiovascular events in psoriasis. Methods We performed a historical cohort and a nested case–cohort study using the population‐based resources in Olmsted County, Minnesota. The study population included a population‐based incidence cohort of patients with psoriasis first diagnosed between January 1, 1970, and January 1, 2000, and 2678 age‐ and sex‐matched non‐psoriasis subjects. Cardiovascular events, including hospitalized myocardial infarction, coronary revascularization procedures, stroke, heart failure, and cardiovascular death. Results Psoriasis was associated with an increased risk of myocardial infarction based on diagnostic codes (hazard ratio 1.26; 95% confidence intervals: 1.01, 1.58) but not when the analyses were restricted to validated myocardial infarction (hazard ratio 1.18; 95% confidence intervals: 0.80, 1.74). Psoriasis was not associated with an increased risk of heart failure or cardiovascular death. Traditional cardiovascular risk factors were significantly associated with cardiovascular risk in psoriasis. Each 1% increase in Framingham risk score at psoriasis incidence corresponded with a 5–10% increase in risk of cardiovascular events. Conclusion In this large incidence cohort of patients with psoriasis representing the full disease severity spectrum, psoriasis was not associated with an increased cardiovascular risk.