Prospective evaluation of cardiovascular risk and mortality in patients with psoriasis: A population-base study

银屑病 医学 内科学 全国健康与营养检查调查 优势比 人口 前瞻性队列研究 银屑病面积及严重程度指数 冠状动脉疾病 皮肤病科 环境卫生
作者
Qitao Chen,Junyan Kan,Qiuwei Tao,Li‐Da Wu,Dongchen Wang,Zihao Jiang,Xufeng Du,Yue Gu,Yong Gu,Shao-Liang Chen
出处
期刊:Research Square - Research Square
标识
DOI:10.21203/rs.3.rs-3152170/v1
摘要

Abstract Background The association between psoriasis and cardiovascular disease (CVD) has long been discussed and continually refined. However, there is currently a lack of prospective studies on the cardiovascular risk attributed to psoriasis in the general population. Methods Representative adult participants were selected from the National Health and Nutrition Examination Survey (NHANES). Risks of cardiovascular symptoms and diseases prevalence were evaluated between participants with and without psoriasis. The hazards for all-cause mortality and CVD mortality were stratified by psoriasis status. Mediation analysis was then conducted to identify potential mediators between psoriasis and cardiac death. Results Overall, 19,741 participants were included in the current study, 542 (2.7%) had psoriasis and 19,199 (97.3%) did not have psoriasis. After adjusting for known CVD risk factors, odds for hypertension (OR = 1.37, 95% CI: 1.13-1.66, p = 0.001), hypercholesterolemia (OR = 1.37, 95% CI: 1.13-1.64, p < 0.001) and angina pectoris (OR = 1.74, 95% CI: 1.11-2.60, p = 0.011) were higher in psoriasis patients. Compared with participants without psoriasis, moderate/severe but not mild patients showed significantly higher CVD mortality (HR = 2.55, 95% CI: 1.27-5.15, p = 0.009). This result was supported by subgroup analyses. Mediation analysis further suggested that the direct effect of moderate/severe psoriasis on CVD mortality accounted for 81.4% (65.8%-97.1%). Besides, the indirect effect might derive from disturbance of serum albumin, urea nitrogen and uric acid. Conclusions Moderate-to-severe psoriasis is an independent risk factor for cardiovascular disease, making it necessary to regularly conduct cardiovascular disease-related examinations for patients with higher severity of psoriasis in clinical settings.
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