Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish Nationwide Cohort Study

O Ahlehoff, GH Gislason, CH Jørgensen… - European heart …, 2012 - academic.oup.com
O Ahlehoff, GH Gislason, CH Jørgensen, J Lindhardsen, M Charlot, JB Olesen
European heart journal, 2012academic.oup.com
Aims Psoriasis is a chronic inflammatory disease and inflammation contributes to the
pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the
risk of these endpoints in patients with psoriasis. Methods and results Cohort study of the
entire Danish population followed from 1997 to 2006 by individual-level-linkage of
nationwide prospectively recorded registers. Multivariable Poisson's regression and
sensitivity analyses were used to assess the psoriasis-related risk of AF and ischaemic …
Aims
Psoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis.
Methods and results
Cohort study of the entire Danish population followed from 1997 to 2006 by individual-level-linkage of nationwide prospectively recorded registers. Multivariable Poisson's regression and sensitivity analyses were used to assess the psoriasis-related risk of AF and ischaemic stroke. A total of 36 765 patients with mild psoriasis and 2793 with severe psoriasis were compared with 4 478 926 individuals, i.e. the reference population. In patients with mild psoriasis, the adjusted rate ratios (RRs) for AF were 1.50 (1.21–1.86) and 1.16 (1.08–1.24) in patients aged <50 and ≥50 years, respectively. Patients with severe psoriasis had a higher risk of AF with RRs 2.98 (1.80–4.92) in patients aged <50 years and 1.29 (1.01–1.65) in patients aged ≥50 years. Patients with psoriasis also demonstrated a disease severity-dependent increased risk of ischaemic stroke, i.e. RRs 1.97 (1.66–2.34) and 2.80 (1.81–4.34) in patients aged <50 years with mild and severe psoriasis, and RRs 1.13 (1.04–1.21) and 1.34 (1.04–1.71) in patients aged ≥50 years with mild and severe psoriasis, respectively. A range of sensitivity analyses yielded comparable results.
Conclusion
Psoriasis is associated with increased risk of AF and ischaemic stroke. These novel results add to a growing body of evidence, suggesting that patients with psoriasis could be considered at increased cardiovascular risk.
Oxford University Press