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Psoriasis and risk of myocardial infarction before and during an era with biological therapy: a population‐based follow‐up study
Author(s) -
Leisner M.Z.,
Lindorff Riis J.,
Gniadecki R.,
Iversen L.,
Olsen M.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15021
Subject(s) - medicine , psoriasis , population , myocardial infarction , cohort , incidence (geometry) , cumulative incidence , cohort study , pediatrics , immunology , physics , environmental health , optics
Background Attention towards cardiovascular disease prevention in patients with moderate to severe psoriasis increased with the introduction of biological therapy. Objective To determine the risk of myocardial infarction ( MI ) following hospital‐diagnosed psoriasis compared with the general population, in eras before and following the introduction of biological therapy. Methods We conducted a cohort study in Denmark utilising nationwide prospectively collected data from population‐based registries. For the early era cohort, we identified subjects with first time hospital‐diagnosed psoriasis between 1995 and 2002, and, for the late era cohort, those diagnosed between 2006 and 2013. Comparison cohorts from the general population were matched (10:1) on sex and birth year. All individuals were followed from date of psoriasis diagnosis (index date for matched controls) until incidence of MI , death, emigration or end of study (1 January 2002 for the early era cohort; 1 January 2013 for the late era cohort). We computed the cumulative MI incidence at 5 years of follow‐up, and used Cox regression to compute HR s of MI comparing psoriasis subjects with general population subjects. Results For the early era, we identified 4302 psoriatic subjects and 43 791 general population subjects; and for the late era, 4577 psoriatic subjects (4% received biologic therapy) and 46 376 general population subjects. The cumulative incidence of MI among psoriatic subjects in the early era was 2.5% and it was 2.2% in the late era. The HR s comparing MI risk in the psoriasis and general population cohorts were 1.40 (95% CI : 1.09–1.80), for the early era, and 1.39 (95% CI : 1.10–1.75) for the late era, adjusting for educational level and use of cardiovascular drugs. Conclusion The increased risk of MI among patients with hospital‐diagnosed psoriasis, relative to the general population, remained unchanged during the initial years of increased attention towards cardiovascular disease prevention and availability of biologic therapy.