Psoriasis and risk of heart failure: a nationwide cohort study

Usman Khalid, Ole Ahlehoff, Gunnar Hilmar Gislason, Søren Lund Kristensen, Lone Skov, Christian Tobias Torp-Pedersen, Peter Riis Hansen

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Abstract

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.

Original languageEnglish
JournalEuropean Journal of Heart Failure
Volume16
Issue number7
Pages (from-to)743-748
Number of pages6
ISSN1388-9842
DOIs
Publication statusPublished - Jul 2014

Keywords

  • Adult
  • Antirheumatic Agents
  • Arthritis, Psoriatic
  • Cardiovascular Agents
  • Cohort Studies
  • Denmark
  • Heart Failure
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Psoriasis
  • Risk Factors
  • Severity of Illness Index
  • Young Adult

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