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In-hospital isolated coronary artery bypass grafting outcomes in patients with psoriasis: a population-based National
Renxi Li1, SeungEun Lee2, Deyanira J Prastein3
1The George Washington University School of Medicine and Health Sciences, WA, D.C., USA; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Insights
Psoriasis patients undergoing coronary artery bypass grafting (CABG) had similar in-hospital outcomes compared to non-psoriasis patients. This suggests CABG is a safe and effective procedure for individuals with psoriasis, despite their increased cardiovascular risk.
Area of Science:
- Cardiology
- Dermatology
- Public Health
Background:
- Psoriasis shares inflammatory pathways with atherosclerosis, a known risk factor for coronary artery disease.
- While psoriasis increases coronary artery disease risk, its impact on outcomes after coronary artery bypass grafting (CABG) is not well-established.
Purpose of the Study:
- To compare in-hospital outcomes of isolated CABG between patients with and without psoriasis.
- To analyze population-based data from a national database to assess CABG outcomes in psoriasis patients.
Main Methods:
- Utilized the National Inpatient Sample (NIS) database from Q4 2015-2021 for patients undergoing isolated CABG.
- Excluded patients under 18 and those with concomitant procedures.
- Employed 1:2 propensity-score matching to balance demographic, socioeconomic, comorbidity, and admission characteristics between psoriasis and non-psoriasis groups.
Main Results:
- Identified 1,732 psoriasis patients (0.95%) among isolated CABG recipients; they were younger and more socioeconomically advantaged.
- After propensity-score matching, in-hospital mortality (1.39% vs 1.03%) and major adverse cardiovascular events (1.45% vs 1.86%) were comparable between groups.
- Psoriasis patients showed a slightly lower risk of venous thromboembolism (0.23% vs 0.67%).
Conclusions:
- Psoriasis patients were underrepresented in CABG procedures relative to their general population prevalence.
- Propensity-score matching revealed comparable in-hospital outcomes for CABG in psoriasis and non-psoriasis patients.
- CABG appears to be a safe and effective treatment option for patients with psoriasis, despite associated cardiovascular risks.
Background:
Psoriasis is a chronic skin disease that shares common inflammatory pathways with atherosclerosis. Although psoriasis is known to increase risk of developing coronary artery disease, the impact of psoriasis on outcomes after coronary artery bypass grafting (CABG) remains less established. This study aimed to compare the in-hospital outcomes of isolated CABG between patients with and without psoriasis through a population-based analysis of a national database.
Methods:
Patients underwent CABG were selected from National Inpatient Sample from Q4 2015-2021. Patients with age <18 years and concomitant procedures were excluded. A 1:2 propensity-score matching was used to match demographics, socioeconomic status, primary payer status, hospital characteristics, comorbidities, and transfer/admission status between psoriasis and non-psoriasis patients. In-hospital outcomes were assessed.
Results:
There were 1,732 (0.95%) patients who underwent isolated CABG who had psoriasis. Patients with psoriasis were younger and more socioeconomically advantaged. After propensity-score matched to 3598 out of 191,175 non-psoriasis patients, patients with and without psoriasis had comparable in-hospital mortality rates (1.39% vs 1.03%, p = 0.27) and major adverse cardiovascular event (1.45% vs 1.86%, p = 0.31). Psoriasis patients had a slightly lower risk of venous thromboembolism (0.23% vs 0.67%, p = 0.04). All other in-hospital outcomes were comparable between psoriasis and non-psoriasis patients.
Conclusions:
The representation of psoriasis patients in CABG was lower than their prevalence in the general population. After propensity-score matching, outcomes for patients with and without psoriasis were comparable. Thus, despite the elevated cardiovascular risks associated with psoriasis, CABG may be as safe and as effective for these patients.
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