Psoriasis and risk of heart failure: a nationwide cohort study

• Published in: European journal of heart failure Vol. 16; no. 7; pp. 743 - 748
• Main Authors: Khalid, Usman, Ahlehoff, Ole, Gislason, Gunnar Hilmar, Kristensen, Søren Lund, Skov, Lone, Torp-Pedersen, Christian, Hansen, Peter Riis
• Format: Journal Article
• Language: English
• Published: Oxford, UK John Wiley & Sons, Ltd 01.07.2014
• Subjects: Adult; Antirheumatic Agents - therapeutic use; Arthritis, Psoriatic - epidemiology; Cardiovascular Agents - therapeutic use; Cardiovascular risk; Cohort Studies; Denmark - epidemiology; Epidemiology; Heart failure; Heart Failure - drug therapy; Heart Failure - epidemiology; Humans; Inflammation; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Psoriasis; Psoriasis - drug therapy; Psoriasis - epidemiology; Risk Factors; Severity of Illness Index; Young Adult; Denmark; Heart failure; Inflammation; Psoriasis; Epidemiology; Cardiovascular risk
• ISSN: 1388-9842; 1879-0844; 1879-0844
• DOI: 10.1002/ejhf.113

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.