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Risk of myocardial infarction and stroke in patients with keloids: A nationwide population-based cohort study
Taehee Jo1, Woonhyeok Jeong1, Jeong Yeop Ryu2
1Department of Plastic and Reconstructive Surgery, Dongsan Hospital, Keimyung University School of Medicine, Republic of Korea.
Insights
Keloids, a skin condition, are linked to a higher risk of heart attack (MI) and ischemic stroke (IS). This increased cardiovascular disease risk persists even after accounting for other known risk factors.
Area of Science:
- Dermatology
- Cardiology
- Epidemiology
Background:
- Keloids are benign fibroproliferative skin disorders.
- Previous research suggests a link between fibroproliferative conditions and cardiovascular disease (CVD).
- The specific association between keloids and major adverse cardiovascular events (MACE) like myocardial infarction (MI) and stroke is not well-established.
Purpose of the Study:
- To investigate the association between keloids and the risk of major adverse cardiovascular events (MACE).
- To examine the incidence rates and relative hazards of myocardial infarction (MI), ischemic stroke (IS), and hemorrhagic stroke (HS) in patients with keloids compared to controls.
Main Methods:
- A nationwide population-based cohort study.
- Inclusion of 554,501 patients with keloids and 1,109,002 matched controls.
- Utilized stratified Cox regression hazard models to calculate relative hazards for MI, IS, and HS.
Main Results:
- Patients with keloids showed elevated incidence rate ratios for MI (1.08), IS (1.06), and HS (1.05).
- Adjusted analyses revealed a persistent increased risk for MI (HR 1.04) and IS (HR 1.03) in keloid patients, independent of traditional CVD risk factors.
- Risk elevations were more pronounced in older adults (≥50 years), women, obese individuals, and nonsmokers.
Conclusions:
- Keloids are significantly associated with an increased risk of MI and IS.
- This association is independent of established cardiovascular risk factors.
- The elevated risk is particularly notable in specific demographic groups: older adults, women, obese individuals, and nonsmokers.
Background:
Keloids represent a form of benign fibroproliferative disorder. Prior studies have linked various fibroproliferative conditions to an increased cardiovascular disease risk; however, the relationship between keloids and major adverse cardiovascular events, such as myocardial infarction (MI) and stroke, remains inadequately explored. A comprehensive nationwide population-based cohort approach was used to examine the cardiovascular disease risk in patients with keloids.
Methods:
The cohort comprised 554,501 patients with keloid and 1,109,002 matched controls. Primary measures included the incidence rates and incidence rate ratios of MI, ischemic stroke (IS), and hemorrhagic stroke (HS) compared to the matched controls. The study applied a stratified Cox regression hazard model to compute the relative hazards between patients with keloid and the controls.
Results:
Incidence rate ratios for cardiovascular diseases in patients with keloid, relative to controls, were 1.08 (95% confidence interval [CI], 1.06-1.10) for MI, 1.06 (CI, 1.04-1.08) for IS, and 1.05 (CI, 1.01-1.08) for HS. After adjusting for additional cardiovascular risk factors, a persistent elevated risk for MI and IS was evident in patients with keloid with adjusted hazard ratios (HRs) of 1.04 (CI 1.01-1.07) for MI and 1.03 (CI 1.00-1.07) for IS. Stratified analyses by age, sex, body mass index, and smoking status revealed consistent risk elevations in older individuals (≥50 years), women, obese individuals, and nonsmokers.
Conclusions:
Keloids are associated with a significant increase in MI and IS risk, independent of the traditional cardiovascular risk factors. This association is particularly prominent in older adults, women, obese individuals, and nonsmokers.
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