Mortality in patients with psoriasis. A retrospective cohort study

Med Clin (Barc). 2017 Jun 7;148(11):483-488. doi: 10.1016/j.medcli.2016.12.011. Epub 2017 Jan 22.
[Article in English, Spanish]

Abstract

Background and objectives: The immune and inflammatory pathways involved in psoriasis could favor the development of atherosclerosis, consequently increasing mortality. The objectives of this study were: 1) to assess the mortality of a population with psoriasis compared to a control group, and 2) to assess the prevalence of cardiovascular risk factors.

Patients and method: A retrospective cohort was analyzed from a secondary database (electronic medical record). All patients with a diagnosis of psoriasis at 1-01-2010 were included in the study and compared to a control group of the same health system, selected randomly (1:1). Subjects with a history of cardiovascular disease were excluded from the study. A survival analysis was performed considering death from any cause as an event. Follow-up was extended until 30-06-2015.

Results: We included 1,481 subjects with psoriasis and 1,500 controls. Prevalence of cardiovascular risk factors was higher in the group with psoriasis. The average follow-up time was 4.6±1.7 years. Mortality was higher in psoriasis patients compared to controls (15.1 vs. 9.6 events per 1,000 person-year, P<.005). Psoriasis was seen to be significantly associated with increased mortality rates compared to the control group in the univariate analysis (HR 1.58, 95% CI 1.16-2.15, P=.004) and after adjusting for cardiovascular risk factors (HR 1.48, 95% CI 1.08-2.3, P=.014).

Conclusion: In this population, patients with psoriasis showed a higher prevalence for the onset of cardiovascular risk factors as well as higher mortality rates during follow-up.

Keywords: Cardiovascular risk factors; Factores de riesgo cardiovascular; Mortalidad; Mortality; Psoriasis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Argentina / epidemiology
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Psoriasis / complications
  • Psoriasis / mortality*
  • Retrospective Studies
  • Risk Factors
  • Young Adult