Elevated risk of atrial fibrillation in patients with psoriasis: an updated systematic review and meta-analysis

Q: What are the key findings of this study?

Psoriasis was associated with a 27% increased risk of developing atrial fibrillation compared to controls without psoriasis (HR 1.27; 95% CI 1.17-1.38; p < 0.05).

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Psoriasis (n=11579730). Intervention: Psoriasis vs. Individuals without psoriasis. Primary outcome: Incident atrial fibrillation (HR 1.27, 95% CI 1.17-1.38, p=<0.05).

Q: What does this research mean for the field?

Psoriasis is associated with a 27% increased risk of developing atrial fibrillation. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the association between psoriasis and the risk of developing incident atrial fibrillation.

Mohammad Hazique; S Varsha Banda; Rubab Rizwan; Sehneet Grewal; Yasemin Bahar; Ali Al-Ramadan; Abdul Rasheed Bahar; Antonio Halais Frangieh; M. Chadi Alraies

doi:10.1007/s00403-026-04856-5

October 30, 2026Archives of Dermatological ResearchOpen Access

Elevated risk of atrial fibrillation in patients with psoriasis: an updated systematic review and meta-analysis

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Key result

Psoriasis is linked to ~27% higher risk of incident AF compared to controls.

HR 1.27
95% CI 1.17-1.38
P<0.05
n=11,579,730

Why the study?

Psoriasis is associated with an increased risk of cardiovascular disease, but its specific association with atrial fibrillation was unclear.

Does psoriasis increase the risk of developing incident atrial fibrillation compared to controls without psoriasis in adult observational cohorts?

Key Points

To evaluate the association between psoriasis and the risk of developing incident atrial fibrillation.
Systematic review and meta-analysis across five databases through December 2024 following PRISMA guidelines, including 8 observational studies.
Analyzed data from 11,579,730 participants (277,597 with psoriasis and 11,302,133 controls) using the Newcastle-Ottawa Scale and random-effects models.
Psoriasis was associated with a higher risk of atrial fibrillation (HR: 1.27; 95% CI: 1.17–1.38, p < 0.05), accompanied by substantial between-study heterogeneity (I² = 92.23%).
Severe psoriasis showed a numerically higher risk (HR: 1.32; 95% CI: 1.22–1.42, p < 0.05) than mild psoriasis (HR: 1.22; 95% CI: 1.11–1.33, p < 0.05), though the between-group difference was not statistically significant (p = 0.46).
Subgroup analyses showed comparable risk estimates in Asian (HR: 1.27; 95% CI: 1.17–1.37) and non-Asian populations (HR: 1.28; 95% CI: 1.14–1.42; p = 0.90), as well as between older (mean age ≥ 45 years, HR: 1.32) and younger cohorts (< 45 years, HR: 1.28; p = 0.60).

Study Design

Type

Meta-Analysis (n=11,579,730)

Multicenter

Yes

Structured PICO

Does psoriasis increase the risk of developing incident atrial fibrillation compared to controls without psoriasis in adult observational cohorts?

P

Population

11,579,730 participants (277,597 with psoriasis and 11,302,133 controls) across 8 observational studies evaluating the risk of developing atrial fibrillation.

E

Exposure

Psoriasis (mild, moderate, or severe, classified according to original study criteria including treatment-based definitions such as use of systemic or biologic therapy or clinical severity categorization)

C

Comparator

Control individuals without psoriasis

O

Outcome

Risk of developing incident atrial fibrillation (defined by clinical diagnosis, diagnostic coding, or validated ICD coding algorithms)hard clinical

Main Result

Hazard Ratio: 1.27 (95% CI 1.17–1.38)

p-value: p=<0.05

This meta-analysis of over 11.5 million individuals demonstrates that psoriasis is associated with a 27% increased risk of incident atrial fibrillation, supporting heightened cardiovascular risk awareness and modifiable risk factor management in patients with psoriasis.

Limitations

Significant between-study heterogeneity (I² = 92.23%)
Observational nature of included studies and lack of randomized controlled trials prevent establishing causality
Residual confounding from unmeasured risk factors such as smoking, obesity, and coronary artery disease
Lack of stratification by systemic or biologic psoriasis treatments
Potential publication bias and small-study effects indicated by mild funnel plot asymmetry
Pooling of hazard ratios, risk ratios, and one odds ratio into a single relative-risk measure
Significant heterogeneity was observed across the included studies (I² = 92.23%), likely due to differences in study design, populations, and methods of classifying psoriasis severity.
Lack of randomized controlled trials (RCTs) limits the ability to establish causality between psoriasis and atrial fibrillation.
Observational nature of included studies introduces potential biases and unmeasured confounders such as smoking, obesity, and coronary artery disease.
Meta-regression analyses were based on a small number of studies relative to covariates and relied on study-level aggregate data, making them exploratory and susceptible to the ecological fallacy.
The review was not prospectively registered in a public registry such as PROSPERO, and mild funnel plot asymmetry suggests potential publication bias.

Implication

Psoriasis may warrant AF vigilance in select patients; extends inflammatory CVD links but remains hypothesis-generating pending prospective data.

Abstract

Psoriasis is a chronic inflammatory skin condition that is associated with an increased risk of cardiovascular disease. However, the association between psoriasis and atrial fibrillation (AF) is unclear. This meta-analysis investigates the relationship between psoriasis and atrial fibrillation (AF). A systematic search was conducted across multiple databases until December 2024 following the PRISMA guidelines. Observational studies assessing psoriasis and AF association were included. Quality assessment of included studies was done according to the Newcastle-Ottawa Scale. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a random effects approach. The subgroup analyses by psoriasis severity, age, quality, and region were conducted. Publication bias was assessed using funnel plots and Egger’s regression. Eight studies (11,579,730 participants; 277,597 with psoriasis) were analyzed. Psoriasis was associated with higher AF risk (HR: 1.27; 95% CI: 1.17–1.38, p < 0.05). Severe psoriasis (HR: 1.32) and older patients with mean age ≥ 45 years (HR: 1.32) showed numerically higher point estimates. Regional analysis revealed comparable risks in Asia (HR: 1.27) and non-Asia (HR: 1.28), although none of the between-subgroup differences (by severity, age, or region) reached statistical significance ( p > 0.05). No significant publication bias was found. This meta-analysis supports an association between psoriasis and increased AF risk. Point estimates were numerically higher in severe psoriasis and in older cohorts, but no between-subgroup difference reached statistical significance, and substantial heterogeneity limits the certainty of these findings. Further research is needed to validate these findings and explore underlying mechanisms.

Discussion

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Cite This Study

Hazique et al. (2026) conducted a meta-analysis in Psoriasis (n=11,579,730). Psoriasis vs. Individuals without psoriasis was evaluated on Incident atrial fibrillation (HR 1.27, 95% CI 1.17-1.38, p=<0.05). Psoriasis was associated with a 27% increased risk of developing atrial fibrillation compared to controls without psoriasis (HR 1.27; 95% CI 1.17-1.38; p < 0.05).

synapsesocial.com/papers/6ae682cae432e7a5c4ef3768 https://doi.org/10.1007/s00403-026-04856-5

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Elevated risk of atrial fibrillation in patients with psoriasis: an updated systematic review and meta-analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Elevated risk of atrial fibrillation in patients with psoriasis: an updated systematic review and meta-analysis

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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