Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients

Area of Science:

• Dermatology
• Cardiology
• Epidemiology

Background:

• Psoriasis is a chronic inflammatory disease with potential systemic implications.
• Previous research suggests a link between psoriasis and increased cardiovascular disease risk.
• The impact of psoriasis severity and disease onset age on cardiovascular mortality requires further investigation.

Purpose of the Study:

• To evaluate cardiovascular mortality rates in patients with psoriasis.
• To determine if psoriasis severity, measured by hospitalization frequency and age at onset, influences cardiovascular mortality risk.

Main Methods:

• Historical cohort study utilizing the Swedish Inpatient Registry and Swedish Psoriasis Association membership.
• Comparison of cardiovascular disease mortality between psoriasis patients (inpatients and outpatients) and the general population.
• Analysis of standardized mortality ratios (SMR) and confidence intervals (CI), assessing trends by admission frequency and age at first admission.

Main Results:

• No increased cardiovascular mortality was observed in psoriasis outpatients (SMR 0.94).
• A 50% increased cardiovascular mortality risk was found in inpatients (SMR 1.52), escalating with admission frequency.
• Younger age at first admission (<39 years) significantly increased cardiovascular mortality risk, particularly with repeated hospitalizations (p for trend <0.001).

Conclusions:

• Psoriasis diagnosis alone is not associated with elevated cardiovascular mortality.
• Severe psoriasis, characterized by frequent hospital admissions and early onset, significantly increases the risk of cardiovascular death.
• Risk stratification for cardiovascular events in psoriasis patients should consider disease severity and age at onset.