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- Title
Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study.
- Authors
Ahlehoff, O.; Gislason, G. H.; Charlot, M.; Jørgensen, C. H.; Lindhardsen, J.; Olesen, J. B.; Abildstrøm, S. Z.; Skov, L.; Torp-Pedersen, C.; Hansen, P. R.
- Abstract
Objective. The magnitude of the cardiovascular risk from psoriasis and psoriatic arthritis is debated. We therefore investigated the psoriasis-related risk of adverse cardiovascular events and mortality. Design, setting and subjects. We conducted a cohort study of the entire Danish population aged 18 years followed from 1997 to 2006 by individual-level linkage of nationwide registers. Psoriasis was defined by prescription claims and classified as severe if patients received hospital-based treatment. Time-dependent Poisson regression models were applied to assess cardiovascular risk in patients with psoriasis and psoriaticarthritis. Main outcome measures. All-cause mortality, cardiovascular mortality and hospitalizations for myocardial infarction (MI), stroke and coronary revascularization were recorded. Results. A total of 34 371 patients with mild psoriasis and 2621 with severe psoriasis, including 607 with psoriatic arthritis,were identified and comparedwith 4 003 265 controls. The event rates and rate ratios (RRs) of all-cause mortality, cardiovascular death, MI, coronary revascularization, strokeanda composite of MI, stroke and cardiovascular death were increased in patients with psoriasis. The rate ratio increased with disease severity and decreased with age of onset. The overall RRs for the composite endpoint were 1.20 (95% confidence interval [CI] 1.14-1.25) and 1.58 (95%CI 1.36-1.82) formild and severe psoriasis, respectively. The corresponding RRs for cardiovascular death were 1.14 (95% CI 1.06-1.22) and 1.57 (95% CI1.27-1.94). The risk was similar in patients with severe skin affection alone and those with psoriaticarthritis. Conclusions. Psoriasis is associated with increased risk of adverse cardiovascular events and all-cause mortality. Young age, severe skin affection and/ or psoriatic arthritis carry the most risk. Patients with psoriasismay be candidates for early cardiovascular risk factor modification.
- Subjects
DENMARK; DISEASE risk factors; PSORIASIS; CARDIOVASCULAR diseases; COHORT analysis; POPULATION research; REGRESSION analysis
- Publication
Journal of Internal Medicine, 2011, Vol 270, Issue 2, p147
- ISSN
0954-6820
- Publication type
Article
- DOI
10.1111/j.1365-2796.2010.02310.x