Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study
Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains un...
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Published in | PloS one Vol. 16; no. 5; p. e0250216 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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Public Library of Science
07.05.2021
Public Library of Science (PLoS) |
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ISSN | 1932-6203 1932-6203 |
DOI | 10.1371/journal.pone.0250216 |
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Abstract | Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93–1.48;
p
= 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank
p
= 0.157). In conclusion, AA does not increase the risk of HD. |
---|---|
AbstractList | About the Authors: Heera Lee Roles Writing – original draft Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea ORCID logo https://orcid.org/0000-0002-5448-2274 You Chan Kim Roles Writing – review & editing Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea Jee Woong Choi Roles Supervision * E-mail: dermaboy@gmail.com Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea ORCID logo https://orcid.org/0000-0003-4631-7823 Introduction Alopecia areata (AA) is an autoimmune disorder that results in non-scarring hair loss due to an inflammatory response in the hair follicles.
The study subjects were followed up until they were diagnosed with HDs such as heart failure (HF), angina pectoris (AP), acute myocardial infarction (AMI), and chronic myocardial infarction (CMI) with the corresponding ICD-10 codes (HF [I50 and its subclassification codes], AP [I20 and its subclassification codes], AMI [I21, I22, I23, and I24 and its subclassification codes], CMI [I25 and its subclassification codes])during the observation period (from January 2004 to December 2013).
After adjusting for significant differences, we obtained hazard ratios (HRs) and 95% confidence intervals (CIs) by Cox proportional hazard regression analysis.
Ethical statement The present study used de-identified data and was approved by the Institutional Review Board of the Ajou University Hospital (IRB-No: AJIRB-MED-EXP-18-404). About the Authors: Heera Lee Roles Writing – original draft Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea ORCID logo https://orcid.org/0000-0002-5448-2274 You Chan Kim Roles Writing – review & editing Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea Jee Woong Choi Roles Supervision * E-mail: dermaboy@gmail.com Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea ORCID logo https://orcid.org/0000-0003-4631-7823 Introduction Alopecia areata (AA) is an autoimmune disorder that results in non-scarring hair loss due to an inflammatory response in the hair follicles. The study subjects were followed up until they were diagnosed with HDs such as heart failure (HF), angina pectoris (AP), acute myocardial infarction (AMI), and chronic myocardial infarction (CMI) with the corresponding ICD-10 codes (HF [I50 and its subclassification codes], AP [I20 and its subclassification codes], AMI [I21, I22, I23, and I24 and its subclassification codes], CMI [I25 and its subclassification codes])during the observation period (from January 2004 to December 2013). After adjusting for significant differences, we obtained hazard ratios (HRs) and 95% confidence intervals (CIs) by Cox proportional hazard regression analysis. Ethical statement The present study used de-identified data and was approved by the Institutional Review Board of the Ajou University Hospital (IRB-No: AJIRB-MED-EXP-18-404). Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93-1.48; p = 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank p = 0.157). In conclusion, AA does not increase the risk of HD. Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93-1.48; p = 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank p = 0.157). In conclusion, AA does not increase the risk of HD.Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93-1.48; p = 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank p = 0.157). In conclusion, AA does not increase the risk of HD. Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and lupus erythematosus can increase the risk of cardiovascular diseases. However, the relationship between AA and heart diseases (HDs) remains unclear. Therefore, we conducted this retrospective cohort study to evaluate the risk of subsequent HDs in patients with AA. We reviewed 3770 cases of AA and from 18,850 age, sex, and income level-matched controls from the National Health Insurance Service-National Sample Cohort. In the subgroup analysis, patients who suffered from alopecia totalis, alopecia universalis, and ophiasis were designated as patients with severe AA and patients having the disease for over a year were designated as patients with long-standing AA. As a result, we found that AA was not associated with a higher risk of heart failure, angina pectoris, or myocardial infarction. There was no significant increase in the risk of overall HD associated with AA (adjusted hazard ratio: 1.17; 95% confidence interval: 0.93–1.48; p = 0.177). Neither the severity nor the duration of AA was related to an increased risk of HDs. During the study period, AA patients did not show a significantly higher cumulative incidence of HDs than controls (log-rank p = 0.157). In conclusion, AA does not increase the risk of HD. |
Audience | Academic |
Author | Lee, Heera Kim, You Chan Choi, Jee Woong |
AuthorAffiliation | Department of Dermatology, Ajou University School of Medicine, Suwon, Korea King Faisal University, SAUDI ARABIA |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33961663$$D View this record in MEDLINE/PubMed |
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Snippet | Alopecia areata (AA) is an autoimmune skin disease caused by chronic inflammation of hair follicles. Chronic inflammatory skin diseases such as psoriasis and... About the Authors: Heera Lee Roles Writing – original draft Affiliation: Department of Dermatology, Ajou University School of Medicine, Suwon, Korea ORCID logo... |
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SubjectTerms | Adult Aged Alopecia Alopecia Areata - complications Alopecia Areata - epidemiology Angina Angina pectoris Autoimmune diseases Baldness Cardiovascular disease Cardiovascular diseases Codes Cohort analysis Confidence intervals Congestive heart failure Coronary artery disease Dermatitis Dermatology Development and progression Diagnosis Female Follicles Hair Health risks Heart attacks Heart diseases Heart Diseases - epidemiology Heart Diseases - etiology Heart failure Humans Incidence Inflammation Inflammatory response Male Medicine Medicine and Health Sciences Middle Aged Myocardial infarction Population Regression analysis Research and Analysis Methods Retrospective Studies Risk analysis Risk Factors Scars Software Statistical analysis Young Adult |
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Title | Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study |
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