Psoriasis Duration May Accelerate Cardiovascular Events

Close-up of pustular psoriasis, a chronic, hereditary dermatosis
Close-up of pustular psoriasis, a chronic, hereditary dermatosis
Psoriasis is known to be associated with increased risk for cardiovascular events and disease.

The duration of psoriasis may have an impact on the severity of vascular inflammation, accelerating the development of major adverse cardiovascular events (MACE), according to results published in JAMA Dermatology

To examine the effect of psoriasis duration on vascular disease and cardiovascular events, investigators evaluated data from 2 cohort groups: the National Institutes of Health (NIH) cohort, which comprised 190 patients with psoriasis, and the total Danish population cohort, which comprised all Danish citizens age 18 years or older.

Participants in the NIH cohort underwent fludeoxyglucose F 18 positron emission tomography/computed tomography (18-FDG PET/CT) to assess vascular inflammation. In the population cohort, researchers examined the risk for MACE using nationwide registries and comparing adjusted hazard ratios in people who had psoriasis (n=87,161) with those of the general population (n=4,234,793).

Results showed an association between the per-year incremental effect of psoriasis duration and increased vascular inflammation (P =.040), even after adjusting for expected cardiovascular risk factors (P =.002).

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In the population cohort, a total of 152,122 people in the general population and 4472 patients with psoriasis experienced MACE (incidence rate/1000 person-years: 7.56; 95% CI, 7.52-7.60; 10.94; 95% CI, 10.62-11.26, respectively). Psoriasis was linked to a 3.9% increased risk for MACE per year of disease duration in an unadjusted analysis and a 1% increased risk per year of disease in a multivariable analysis.

“Providers should consider inquiring about duration of disease to counsel for heightened [cardiovascular disease] risk in [people with] psoriasis,” investigators concluded.

Reference

Egeberg A, Skov L, Joshi A, et al. The relationship between duration of psoriasis, vascular inflammation, and cardiovascular events. J Am Acad Dermatol. 2017;77:650-656.