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Updated: Jun 30, 2025
Granulocyte-dependent Autoantibody-induced Skin Blistering
Published on: October 12, 2012
Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study
Kasper Bonnesen1, Christian F B Poulsen2, Sigrun A J Schmidt3
1Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Insights
Autoimmune blistering disorders (ABDs) significantly increase the risk of cardiovascular events, including heart failure and death. This study highlights the heightened cardiovascular risk in patients with ABDs compared to the general population.
Area of Science:
- Cardiology
- Dermatology
- Epidemiology
Background:
- Autoimmune blistering disorders (ABDs) are associated with potential cardiovascular risks, though research is limited.
- Understanding this link is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the association between ABDs and the risk of major cardiovascular outcomes.
- Specifically examining atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.
Main Methods:
- A population-based cohort study in Denmark (1996-2021) included 3,322 patients with ABDs.
- A comparison group of 33,195 individuals from the general population, matched for age and sex, was utilized.
Main Results:
- Patients with ABDs exhibited significantly higher 1-year risks for atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death compared to controls.
- Elevated risks persisted for most outcomes over 10 years.
- Hazard ratios indicated substantial increases in risk for cardiovascular death (2.01) and venous thromboembolism (1.87).
Conclusions:
- Patients diagnosed with autoimmune blistering disorders face an elevated risk of cardiovascular disease.
- This increased risk was observed in both pemphigus and pemphigoid subtypes.
- Findings may be most applicable to patients without pre-existing cardiovascular conditions.
Background:
Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking.
Objective:
The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.
Methods:
A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195).
Results:
Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid.
Limitations:
Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases.
Conclusion:
Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls.
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