Psoriasis May Not Be a Risk for CV Events Save

Patients with psoriatic skin and joint disease are uniquely susceptible to multiple comorbidities, obesity and possibly more cardiovascular risks. In rheumatoid arthritis, the increased CV risk and CV events have been closely aligned with inflammation and disease activity. However, the same may not be said for psoriasis.

To study the association between psoriasis and risk of major cardiovascular events (myocardial infarction, acute coronary syndrome, unstable angina, and stroke), a cohort study was performed using patients from the UK Clinical Practice Database.

Psoriasis patients (48,523) and matched controls (208,187) were studied over a median of 5.2 years; CV events were seen in 2.59% of those with psoriasis and 2.3% of controls. Predictors of CV events included inflammatory arthritis (HR1.36; 95% CI 1.18-1.58), diabetes (HR 1.18; 1.06-1.31), chronic kidney disease (HR 1.18; 1.07-1.31), hypertension (HR 1.37; 1.29-1.45), transient ischemic attack (HR 2.74; 2.41-3.12), atrial fibrillation HR 1.54 (1.36-1.73), valvular heart disease (HR 1.23; 1.05-1.44), thromboembolism (HR 1.32; 1.17-1.49), congestive heart failure (HR 1.57; 1.39-1.78), depression (HR 1.16; 1.01-1.34), current smoker (HR 2.18; 2.03-2.33), age (HR 1.07; 1.07-1.07), and male gender (HR 1.83; 1.69-1.98).

However, the fully adjusted hazard ratios failed to show an association between psoriasis (HR 1.02; 0.95-1.08) or severe psoriasis (HR 1.28; 0.96-1.69) and major CV events over a 3-5 year period.

These data suggest psoriasis alone will augment CV risk. Instead, it appears that psoriatic disease associates with many comorbidities that contribute to an overall increase rate of CV events.