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Higher risk of atrial fibrillation, thromboembolic events in severe psoriasis

11 Sep 2017

Severe psoriasis significantly increases the risk of atrial fibrillation (AF) and thromboembolic events (AE), a recent nationwide population-based study from Korea has shown.

The study included 13,385 psoriasis patients, of which 14.5 percent (n=1,947) had severe psoriasis. A total of 739,459 participants without psoriasis were included. The investigators tracked the development of nonvalvular AF. Secondary outcomes were TE, ischaemic stroke and systemic thromboembolism.

The incidence rate of AF in patients without psoriasis was 1.65 per 1,000 patient-years which was lower than that in mild psoriasis (2.48 per 1,000 patient-years) and severe psoriasis (4.05 per 1,000 patient-years) patients.

Similarly, TE incidence rates were higher in severe psoriasis patients (8.14 per 1,000 patient-years) than in mild and nonpsoriasis patients (5.13 and 3.63 per 1,000 patient-years, respectively).

Severe psoriasis significantly increased the risk of AF in both the multivariable (hazard ratio [HR], 1.44; 95 percent CI, 1.14 to 1.82; p=0.002) and propensity score-matched (HR, 1.77; 1.39 to 2.24; p<0.001) models.

Similarly, the risk of TE was also significantly higher in both multivariable (HR, 1.26; 1.07 to 1.47; p=0.005) and propensity score-matched (HR, 1.55; 1.32 to 1.84; p<0.001) models for the severe psoriasis patients.

In contrast, patients with mild psoriasis did not show significantly higher risks of AF (p=0.133 and p=0.365) or TE (p=0.382 to p=0.707) in both multivariable and propensity score-matched models, respectively.

Psoriasis, an autoimmune inflammatory skin disorder, has been shown to be associated with various cardiovascular risk factors. While recent studies have also shown a link between psoriasis and AF or TE, these have failed to control for traditional cardiovascular risk factors leaving the conclusions controversial. [J Am Acad Dermatol 2006:54:614-621; J Invest Dermatol 2013;133:2340-2346]

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Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.