Key result
Severe psoriasis in younger patients is linked to a ~3-fold higher AF risk.
Why the study?
Does psoriasis increase the risk of atrial fibrillation and ischaemic stroke in the general population?
Cohort (n=4,518,484)
Does psoriasis increase the risk of atrial fibrillation and ischaemic stroke in the general population?
Relative Risk: 1.5 (95% CI 1.21–1.86)
Psoriasis is associated with a disease severity-dependent increased risk of atrial fibrillation and ischaemic stroke, particularly in younger patients, suggesting they should be considered at increased cardiovascular risk.
AIMS: Psoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis. METHODS AND RESULTS: Cohort study of the entire Danish population followed from 1997 to 2006 by individual-level-linkage of nationwide prospectively recorded registers. Multivariable Poisson's regression and sensitivity analyses were used to assess the psoriasis-related risk of AF and ischaemic stroke. A total of 36 765 patients with mild psoriasis and 2793 with severe psoriasis were compared with 4 478 926 individuals, i.e., the reference population. In patients with mild psoriasis, the adjusted rate ratios (RRs) for AF were 1.50 (1.21-1.86) and 1.16 (1.08-1.24) in patients aged <50 and ≥50 years, respectively. Patients with severe psoriasis had a higher risk of AF with RRs 2.98 (1.80-4.92) in patients aged <50 years and 1.29 (1.01-1.65) in patients aged ≥50 years. Patients with psoriasis also demonstrated a disease severity-dependent increased risk of ischaemic stroke, i.e. RRs 1.97 (1.66-2.34) and 2.80 (1.81-4.34) in patients aged <50 years with mild and severe psoriasis, and RRs 1.13 (1.04-1.21) and 1.34 (1.04-1.71) in patients aged ≥50 years with mild and severe psoriasis, respectively. A range of sensitivity analyses yielded comparable results. CONCLUSION: Psoriasis is associated with increased risk of AF and ischaemic stroke. These novel results add to a growing body of evidence, suggesting that patients with psoriasis could be considered at increased cardiovascular risk.
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Ahlehoff et al. (2011) conducted a cohort in Psoriasis (n=4,518,484). Psoriasis vs. Reference population without psoriasis was evaluated on Atrial fibrillation in patients aged <50 years with mild psoriasis (RR 1.50, 95% CI 1.21-1.86). Psoriasis was associated with an increased risk of atrial fibrillation and ischaemic stroke, with severe psoriasis in patients <50 years showing an RR of 2.98 (95% CI 1.80-4.92) for AF.
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