Psoriasis and risk of heart failure: a nationwide cohort study

TY - JOUR

T1 - Psoriasis and risk of heart failure

T2 - a nationwide cohort study

AU - Khalid, Usman

AU - Ahlehoff, Ole

AU - Gislason, Gunnar Hilmar

AU - Kristensen, Søren Lund

AU - Skov, Lone

AU - Torp-Pedersen, Christian Tobias

AU - Hansen, Peter Riis

N1 - © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

PY - 2014/7

Y1 - 2014/7

N2 - AIMS: Psoriasis is a common inflammatory disease that is associated with increased risk of cardiovascular disease, including myocardial infarction. Heart failure (HF) is independently associated with several cardiovascular risk factors and is a major cause of cardiovascular morbidity and mortality. The association between psoriasis and HF is unclear and we therefore investigated the risk of new-onset HF in a nationwide cohort of psoriasis patients compared with the background population.METHODS: The study included the entire Danish population aged ≥18 years followed from 1 January 1997 until HF, death or 31 December 2011. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. New-onset HF was defined as first hospital admission for HF. Incidence rates of new-onset HF were calculated and adjusted hazard ratios were estimated by multivariable Cox regression models adjusted for age, gender, comorbidity and cardiovascular medications.RESULTS: A total of 5 485 856 subjects were eligible for analysis. In the study period 66 389 patients with new-onset psoriasis, including 11 242 patients with severe psoriasis, were identified. The overall incidence rates of new-onset HF were 2.82, 4.22 and 4.70 per 1000 person-years for the reference population, mild psoriasis and severe psoriasis, respectively. Compared with the reference population, the fully adjusted hazard ratios for new-onset HF were increased in patients with psoriasis with a hazard ratio 1.22 (95% confidence interval 1.16-1.29) and hazard ratio of 1.53 (95% confidence interval 1.34-1.74) for those with mild and severe disease, respectively.CONCLUSION: In this nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of new-onset HF.

AB - AIMS: Psoriasis is a common inflammatory disease that is associated with increased risk of cardiovascular disease, including myocardial infarction. Heart failure (HF) is independently associated with several cardiovascular risk factors and is a major cause of cardiovascular morbidity and mortality. The association between psoriasis and HF is unclear and we therefore investigated the risk of new-onset HF in a nationwide cohort of psoriasis patients compared with the background population.METHODS: The study included the entire Danish population aged ≥18 years followed from 1 January 1997 until HF, death or 31 December 2011. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. New-onset HF was defined as first hospital admission for HF. Incidence rates of new-onset HF were calculated and adjusted hazard ratios were estimated by multivariable Cox regression models adjusted for age, gender, comorbidity and cardiovascular medications.RESULTS: A total of 5 485 856 subjects were eligible for analysis. In the study period 66 389 patients with new-onset psoriasis, including 11 242 patients with severe psoriasis, were identified. The overall incidence rates of new-onset HF were 2.82, 4.22 and 4.70 per 1000 person-years for the reference population, mild psoriasis and severe psoriasis, respectively. Compared with the reference population, the fully adjusted hazard ratios for new-onset HF were increased in patients with psoriasis with a hazard ratio 1.22 (95% confidence interval 1.16-1.29) and hazard ratio of 1.53 (95% confidence interval 1.34-1.74) for those with mild and severe disease, respectively.CONCLUSION: In this nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of new-onset HF.

KW - Adult

KW - Antirheumatic Agents

KW - Arthritis, Psoriatic

KW - Cardiovascular Agents

KW - Cohort Studies

KW - Denmark

KW - Heart Failure

KW - Humans

KW - Middle Aged

KW - Multivariate Analysis

KW - Proportional Hazards Models

KW - Psoriasis

KW - Risk Factors

KW - Severity of Illness Index

KW - Young Adult

U2 - 10.1002/ejhf.113

DO - 10.1002/ejhf.113

M3 - Journal article

C2 - 24903077

SN - 1567-4215

VL - 16

SP - 743

EP - 748

JO - European Journal of Heart Failure, Supplement

JF - European Journal of Heart Failure, Supplement

IS - 7

ER -