Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack: an inception cohort study with a nested case-control analysis
Summary Background Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce. Objectives To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient...
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| Veröffentlicht in: | British journal of dermatology (1951) 2009-05, Vol.160 (5), p.1048-1056 |
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| container_title | British journal of dermatology (1951) |
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| creator | Brauchli, Y.B. Jick, S.S. Miret, M. Meier, C.R. |
| description | Summary
Background Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce.
Objectives To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis‐free population.
Methods We conducted an inception cohort study with a nested case–control analysis within the U.K.‐based General Practice Research Database. The study population encompassed 36 702 patients with a first‐time recorded diagnosis of psoriasis 1994–2005, matched 1 : 1 to psoriasis‐free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs).
Results Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged 2 prescriptions/year for oral psoriasis treatment were 2·48 (95% CI 0·69–8·91) and 1·39 (95% CI 0·43–4·53), with a similar finding for stroke and TIA.
Conclusions The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged |
| doi_str_mv | 10.1111/j.1365-2133.2008.09020.x |
| format | Article |
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Background Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce.
Objectives To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis‐free population.
Methods We conducted an inception cohort study with a nested case–control analysis within the U.K.‐based General Practice Research Database. The study population encompassed 36 702 patients with a first‐time recorded diagnosis of psoriasis 1994–2005, matched 1 : 1 to psoriasis‐free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs).
Results Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged < 60 years was 1·66 (95% CI 1·03–2·66) compared with patients without psoriasis, while the OR for patients aged ≥ 60 years was 0·99 (95% CI 0·77–1·26). The adjusted ORs of developing MI for patients of all ages with ≤ 2 or > 2 prescriptions/year for oral psoriasis treatment were 2·48 (95% CI 0·69–8·91) and 1·39 (95% CI 0·43–4·53), with a similar finding for stroke and TIA.
Conclusions The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged < 60 years, mainly with severe disease.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/j.1365-2133.2008.09020.x</identifier><identifier>PMID: 19210501</identifier><identifier>CODEN: BJDEAZ</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cardiology. Vascular system ; Case-Control Studies ; Child ; Child, Preschool ; Confidence Intervals ; Coronary heart disease ; Databases, Factual ; Dermatology ; Female ; Heart ; Humans ; incidence rates ; Infant ; Infant, Newborn ; Ischemic Attack, Transient - epidemiology ; Ischemic Attack, Transient - etiology ; Male ; Medical sciences ; Middle Aged ; myocardial infarction ; Myocardial Infarction - epidemiology ; Myocardial Infarction - etiology ; Neurology ; Odds Ratio ; psoriasis ; Psoriasis - complications ; Psoriasis - epidemiology ; Psoriasis. Parapsoriasis. Lichen ; Risk Assessment ; stroke ; Stroke - epidemiology ; Stroke - etiology ; Time Factors ; transient ischaemic attack ; United Kingdom - epidemiology ; Vascular diseases and vascular malformations of the nervous system ; Young Adult</subject><ispartof>British journal of dermatology (1951), 2009-05, Vol.160 (5), p.1048-1056</ispartof><rights>2009 The Authors. Journal Compilation © 2009 British Association of Dermatologists</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5160-f2347dc23045f7c1e548dbd220f299f0f22fbcf801b7fd8f70c68a0422d1b8fb3</citedby><cites>FETCH-LOGICAL-c5160-f2347dc23045f7c1e548dbd220f299f0f22fbcf801b7fd8f70c68a0422d1b8fb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2133.2008.09020.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2133.2008.09020.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21398448$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19210501$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brauchli, Y.B.</creatorcontrib><creatorcontrib>Jick, S.S.</creatorcontrib><creatorcontrib>Miret, M.</creatorcontrib><creatorcontrib>Meier, C.R.</creatorcontrib><title>Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack: an inception cohort study with a nested case-control analysis</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary
Background Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce.
Objectives To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis‐free population.
Methods We conducted an inception cohort study with a nested case–control analysis within the U.K.‐based General Practice Research Database. The study population encompassed 36 702 patients with a first‐time recorded diagnosis of psoriasis 1994–2005, matched 1 : 1 to psoriasis‐free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs).
Results Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged < 60 years was 1·66 (95% CI 1·03–2·66) compared with patients without psoriasis, while the OR for patients aged ≥ 60 years was 0·99 (95% CI 0·77–1·26). The adjusted ORs of developing MI for patients of all ages with ≤ 2 or > 2 prescriptions/year for oral psoriasis treatment were 2·48 (95% CI 0·69–8·91) and 1·39 (95% CI 0·43–4·53), with a similar finding for stroke and TIA.
Conclusions The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged < 60 years, mainly with severe disease.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Confidence Intervals</subject><subject>Coronary heart disease</subject><subject>Databases, Factual</subject><subject>Dermatology</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>incidence rates</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Ischemic Attack, Transient - epidemiology</subject><subject>Ischemic Attack, Transient - etiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>myocardial infarction</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Infarction - etiology</subject><subject>Neurology</subject><subject>Odds Ratio</subject><subject>psoriasis</subject><subject>Psoriasis - complications</subject><subject>Psoriasis - epidemiology</subject><subject>Psoriasis. Parapsoriasis. Lichen</subject><subject>Risk Assessment</subject><subject>stroke</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>Time Factors</subject><subject>transient ischaemic attack</subject><subject>United Kingdom - epidemiology</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><subject>Young Adult</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc2O0zAUhS0EYjoDr4C8gRUJ13Z-HCQWwzAMoBEgDYjuLMc_qtskLnaqaR6Ft8WhVVmCF_aV_Z3jax-EMIGcpPFqnRNWlRkljOUUgOfQAIV8_wAtTgcP0QIA6gyaip2h8xjXAIRBCY_RGWkoSRVZoF9fow9ORhexHDQOLm6wt9gNymkzjLifvJJBO9mlPSuDGp0fXuI4Br8x2Ac8BjlEN6MuqpU0vVNYjqNUm9fJcTYy21mDlV_5MCblTk_43o0rLPFg4mg0VjKaTPkhmXZJJLsp9fMEPbKyi-bpcb1A399ff7v6kN1-ufl4dXmbqZJUkFnKiloryqAoba2IKQuuW00pWNo0Ns3UtspyIG1tNbc1qIpLKCjVpOW2ZRfoxcF3G_zPXWpI9OklpuvkYPwuiqqmUNWc_ROkUHIKTZlAfgBV8DEGY8U2uF6GSRAQc35iLeaYxByTmPMTf_IT-yR9drxj1_ZG_xUeA0vA8yMgo5KdTb-vXDxxybHhRcET9-bA3bvOTP_dgHj76d1cJX120LuU0P6kl2GTPoTVpfjx-Ubclc1yeddUYsl-Ay9-yEw</recordid><startdate>200905</startdate><enddate>200905</enddate><creator>Brauchli, Y.B.</creator><creator>Jick, S.S.</creator><creator>Miret, M.</creator><creator>Meier, C.R.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>200905</creationdate><title>Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack: an inception cohort study with a nested case-control analysis</title><author>Brauchli, Y.B. ; Jick, S.S. ; Miret, M. ; Meier, C.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5160-f2347dc23045f7c1e548dbd220f299f0f22fbcf801b7fd8f70c68a0422d1b8fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Confidence Intervals</topic><topic>Coronary heart disease</topic><topic>Databases, Factual</topic><topic>Dermatology</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>incidence rates</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Ischemic Attack, Transient - epidemiology</topic><topic>Ischemic Attack, Transient - etiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>myocardial infarction</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocardial Infarction - etiology</topic><topic>Neurology</topic><topic>Odds Ratio</topic><topic>psoriasis</topic><topic>Psoriasis - complications</topic><topic>Psoriasis - epidemiology</topic><topic>Psoriasis. Parapsoriasis. Lichen</topic><topic>Risk Assessment</topic><topic>stroke</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>Time Factors</topic><topic>transient ischaemic attack</topic><topic>United Kingdom - epidemiology</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brauchli, Y.B.</creatorcontrib><creatorcontrib>Jick, S.S.</creatorcontrib><creatorcontrib>Miret, M.</creatorcontrib><creatorcontrib>Meier, C.R.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brauchli, Y.B.</au><au>Jick, S.S.</au><au>Miret, M.</au><au>Meier, C.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack: an inception cohort study with a nested case-control analysis</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2009-05</date><risdate>2009</risdate><volume>160</volume><issue>5</issue><spage>1048</spage><epage>1056</epage><pages>1048-1056</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><coden>BJDEAZ</coden><abstract>Summary
Background Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce.
Objectives To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis‐free population.
Methods We conducted an inception cohort study with a nested case–control analysis within the U.K.‐based General Practice Research Database. The study population encompassed 36 702 patients with a first‐time recorded diagnosis of psoriasis 1994–2005, matched 1 : 1 to psoriasis‐free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs).
Results Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged < 60 years was 1·66 (95% CI 1·03–2·66) compared with patients without psoriasis, while the OR for patients aged ≥ 60 years was 0·99 (95% CI 0·77–1·26). The adjusted ORs of developing MI for patients of all ages with ≤ 2 or > 2 prescriptions/year for oral psoriasis treatment were 2·48 (95% CI 0·69–8·91) and 1·39 (95% CI 0·43–4·53), with a similar finding for stroke and TIA.
Conclusions The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged < 60 years, mainly with severe disease.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19210501</pmid><doi>10.1111/j.1365-2133.2008.09020.x</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Biological and medical sciences Cardiology. Vascular system Case-Control Studies Child Child, Preschool Confidence Intervals Coronary heart disease Databases, Factual Dermatology Female Heart Humans incidence rates Infant Infant, Newborn Ischemic Attack, Transient - epidemiology Ischemic Attack, Transient - etiology Male Medical sciences Middle Aged myocardial infarction Myocardial Infarction - epidemiology Myocardial Infarction - etiology Neurology Odds Ratio psoriasis Psoriasis - complications Psoriasis - epidemiology Psoriasis. Parapsoriasis. Lichen Risk Assessment stroke Stroke - epidemiology Stroke - etiology Time Factors transient ischaemic attack United Kingdom - epidemiology Vascular diseases and vascular malformations of the nervous system Young Adult |
| title | Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack: an inception cohort study with a nested case-control analysis |
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