Table 1.
Studies investigating the risk of severe vascular events (including myocardial infarction, cerebrovascular disease, and cardiovascular death) in patients with psoriasis.
| Study | Cardiovascular Comorbidities | Number of Patients/Controls | Relative Risk | Population/Type of Study |
|---|---|---|---|---|
| Abuabara et al., 2010 [32] | Cardiovascular death | Severe psoriasis: 3603; Controls: 14,330 | Hazard ratio: 1.57 (95% CI 1.26–1.96) | United Kingdom/Cohort study |
| Ahlehoff et al., 2011 [41] | Composite endpoint (myocardial infarction, stroke and cardiovascular death) | Mild psoriasis: 34,371; Severe psoriasis: 2621; Controls: 4,003,265 | Rate ratio: Composite endpoint: Mild psoriasis: 1.20 (95% CI 1.14–1.25); Severe psoriasis: 1.58 (95% CI 1.36–1.82); Stroke: Mild psoriasis: 1.25 (95% CI 1.16–1.33); Severe psoriasis: 1.71 (95% CI 1.39–2.11); Myocardial infarction: Mild psoriasis: 1.22 (95% CI 1.12–1.33); Severe psoriasis: 1.45 (95% CI 1.10–1.90); Cardiovascular death: Mild psoriasis: 1.14 (95% CI 1.06–1.22); Severe psoriasis 1.57 (95% CI 1.27–1.94) |
Denmark/Cohort study |
| Ahlehoff et al., 2011 [47] | Composite cardiovascular endpoint (recurrent myocardial infarction, stroke and cardiovascular death) after first time myocardial infarction | Patients with first time myocardial infarction; Psoriasis: 462; Controls: 48,935 | Hazard ratio: 1.26 (95% CI 1.06–1.54) | Denmark/Cohort study |
| Ahlehoff et al., 2012 [40] | Ischemic stroke | Mild psoriasis: 36,765; Severe psoriasis: 2793; Controls: 4,478,926 | Rate ratio: Age < 50 years: Mild psoriasis: 1.97 (95% CI 1.66–2.34); Severe psoriasis: 2.80 (95% CI 1.81–4.34); Age ≥ 50 years: Mild psoriasis: 1.13 (95% CI 1.04–1.21); Severe psoriasis: 1.34 (95% CI 1.04–1.71) |
Denmark/Cohort study |
| Brauchli et al., 2009 [44] | Myocardial infarction, stroke or transient ischemic attack | Psoriasis: 36,702; Controls: 36,702 | Odds ratio: Myocardial infarction: Overall: 1.14 (95% CI 0.93–1.41); Age < 60 years: 1.66 (95% CI 1.03–2.66); Age ≥ 60 years: 0.99 (95% CI 0.77–1.26); Stroke: Overall: 0.93 (95% CI 0.77–1.13); Age < 60 years: 0.52 (95% CI 0.29–0.93); Age ≥ 60 years: 0.99 (95% CI 0.80–1.22); Transient ischemic attack: Overall: 1.00 (95% CI 0.81–1.25); Age < 60 years: 1.28 (95% CI 0.61–2.68); Age ≥ 60 years: 1.02 (95% CI 0.80–1.29) |
United Kingdom/Inception cohort study with nested case-control analysis |
| Chiang et al., 2012 [39] | Ischemic stroke | Psoriasis: 2783; Controls: 13,910 | Hazard ratio: 1.27 (95% CI 1.05–1.52) | Taiwan/Retrospective cohort study |
| Dowlatshahi et al., 2013 [35] | Cardiovascular disease (coronary heart disease, stroke, heart failure) | Psoriasis: 262; Controls: 8009 | Hazard ratio: 0.73 (95% CI 0.50–1.06) | Netherlands/Prospective cohort study |
| Dregan et al., 2014 [45] | Coronary heart disease Stroke |
Severe psoriasis: 5648; Mild psoriasis: 85,232; Controls: 373,851 | Hazard ratio: Mild psoriasis: Stroke: 1.08 (95% CI 0.98–1.18); Coronary heart disease: 1.03 (95% CI 0.97–1.11); Severe psoriasis: Stroke: 0.93 (95% CI 0.64–1.36); Coronary heart disease: 1.29 (95% CI 1.01–1.64) |
United Kingdom/Cohort study |
| Egeberg et al., 2017 [12] | Myocardial infarction | Mild psoriasis: 49,646; Severe psoriasis: 11,957; Controls: 4,300,085 | Hazard ratio: Mild psoriasis: 1.02 (95% CI 0.96–1.09); Severe psoriasis: 1.21 (95% CI 1.07–1.37) |
Denmark/Cohort study |
| Gelfand et al., 2006 [3] | Myocardial infarction | Mild psoriasis: 127,139; Severe psoriasis: 3837; Controls: 556,995 | Relative risk: 30-year-old: Mild psoriasis: 1.29 (95% CI 1.14–1.46); Severe psoriasis: 3.10 (95% CI 1.98–4.86); 60-year-old: Mild psoriasis: 1.08 (95% CI 1.03–1.13); Severe psoriasis: 1.36 (95% CI 1.13–1.64) |
United Kingdom/Prospective cohort study |
| Gelfand et al., 2009 [11] | Stroke | Mild psoriasis: 129,143 (controls: 496,666); Severe psoriasis: 3603 (controls 14,330) | Hazard ratio: Mild psoriasis: 1.06 (95% CI 1.0–1.1); Severe psoriasis: 1.43 (95% CI 1.1–1.9) |
United Kingdom/Cohort study |
| Kaye et al., 2008 [8] | Myocardial infarction Stroke |
Psoriasis: 44,164; Controls: 219,784 | Hazard ratio: Myocardial infarction: 1.21 (95% CI 1.10–1.32); Stroke: 1.12 (95% CI 1.00–1.25) |
United Kingdom/Cohort study |
| Lai et al., 2016 [27] | Myocardial infarction Ischemic heart disease Stroke |
Psoriasis: 520; Total subjects: 19,065 | Odds ratio: Myocardial infarction: 2.24 (95% CI 1.27–3.95); Ischemic heart disease: 1.90 (95% CI 1.18–3.05); Stroke: 1.01 (95% CI 0.48–2.16) |
United States/Cross-sectional study |
| Lan et al., 2012 [48] | Cerebrovascular disease | Psoriasis: 8180; Controls: 163,600 | Hazard ratio: 1.28 (95% CI 1.162–1.413) | Taiwan/Retrospective cohort study |
| Levesque et al., 2013 [29] | Myocardial infarction | Psoriasis: 31,421; Controls: 31,421 | Hazard ratio: 1.17 (95% CI 1.04–1.31) | Canada/Retrospective cohort study |
| Li et al., 2012 [28] | Nonfatal cardiovascular disease (nonfatal myocardial infarction, nonfatal stroke) | Participants: 96,008 (women); Psoriasis: 2463 | Hazard ratio: Myocardial infarction: 1.70 (95% CI 1.01–2.86); Stroke: 1.45 (95% CI 0.80–2.65) |
United States/Cohort study |
| Lin et al., 2011 [30] | Myocardial infarction | Psoriasis: 4752; Controls: 23,760 | Hazard ratio: 2.10 (95% CI 1.27–3.43) | Taiwan/Retrospective cohort study |
| Mallbris et al., 2004 [49] | Cardiovascular mortality | Psoriasis inpatients: 8991; Psoriasis outpatients: 19,757 | Standardized mortality ratio: Inpatients: 1.52 (95% CI 1.44–1.60); Outpatients: 0.94 (95% CI 0.89–0.99) |
Sweden/Cohort study |
| Mehta et al., 2010 [18] | Cardiovascular mortality | Severe psoriasis: 3603; Controls: 14,330 | Hazard ratio: 1.57 (95% CI 1.26–1.96) | United Kingdom/Cohort study |
| Ogdie et al., 2015 [25] | Major adverse cardiovascular events (including myocardial infarction, cerebrovascular accidents and cardiovascular death) | Psoriasis: 138,424; Controls: 81,573 | Hazard ratio: Mild psoriasis (no DMARD): 1.08 (95% CI 1.02–1.15); Severe psoriasis (DMARD user): 1.42 (95% CI 1.17–1.73) |
United Kingdom/Cohort study |
| Prodanovich et al., 2009 [42] | Ischemic heart disease; Cerebrovascular disease; Peripheral vascular disease | Psoriasis: 3236; Controls: 2500 | Odds ratio: Ischemic heart disease: 1.78 (95% CI 1.51–2.11); Cerebrovascular disease: 1.70 (95% CI 1.33–2.17); Peripheral vascular disease: 1.98 (95% CI 1.38–2.82) |
United States/Observational cross-sectional study |
| Shiba et al., 2016 [31] | Coronary heart disease | Hospital-based population: 113,065; Psoriasis: 1197 | Odds ratio: 1.27 (95% CI 1.01–1.58) | Japan/Cross-sectional study |
| Stern et al., 2011 [33] | Cardiovascular mortality | Severe psoriasis: 1376 | Standard mortality ratio: 1.02 (95% CI 0.90–1.16) | United States/Prospective cohort study |
| Wakkee et al., 2010 [34] | Ischemic heart disease hospitalization | Psoriasis: 15,820; Controls: 27,577 | Hazard ratio: 1.05 (95% CI 0.95–1.17) | Netherlands/Cohort study |
| Wu et al., 2015 [26] | Myocardial infarction | Mild psoriasis: 10,173 (controls: 50,865); Severe psoriasis: 3841 (controls: 19,205) | Hazard ratio: Mild psoriasis: 1.31 (95% CI 1.14–1.51); Severe psoriasis: 1.28 (95% CI 1.02–1.60) |
United States/Retrospective cohort study |
CI = confidence interval.