Abstract Background: Psoriasis, a chronic inflammatory skin condition, is linked to an increased risk of cardiovascular diseases due to shared inflammatory pathways. However, the direct impact of psoriasis on cardiovascular risk factors remains underexplored. This study investigates the relationship between psoriasis and cardiovascular events, including Myocardial Infarction (MI), stroke, heart failure, arrhythmias, and thromboembolic diseases. Methods: A nationwide retrospective cohort study was conducted using de-identified Electronic Health Records (EHRs) from 93 healthcare organizations over 20 years. Two cohorts were analyzed: psoriasis patients and non-psoriasis controls, aged 18-60 years. Propensity Score Matching (PSM) balanced baseline characteristics, and the primary outcome was the occurrence of cardiovascular events within 10 years. Survival analyses and Risk Ratios (RR) were used to assess the relationship between psoriasis and cardiovascular outcomes. Results: After matching, each cohort included 120,527 patients. Psoriasis patients had a significantly higher risk of cardiovascular outcomes, with a 28% increased risk of acute MI (RR: 1.28), 23% higher stroke risk (RR: 1.23), 40% higher heart failure risk (RR: 1.40), 60% higher arrhythmia risk (RR: 1.60), and 46% higher thromboembolism risk (RR: 1.46). Psoriasis patients also had higher risks of ischemic heart disease and transient ischemic attacks. Survival analyses showed lower survival probabilities for psoriasis patients across most outcomes. Conclusion: Psoriasis is significantly associated with an increased risk of cardiovascular events, underscoring the need for proactive cardiovascular risk management in psoriasis patients.
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