Increased risk of arrhythmia in patients with psoriatic disease: A nationwide population-based matched cohort study

J Am Acad Dermatol. 2015 Sep;73(3):429-38. doi: 10.1016/j.jaad.2015.06.023. Epub 2015 Jul 15.

Abstract

Background: Psoriasis is associated with cardiovascular morbidity and mortality. However, the association between psoriasis and arrhythmia has not been adequately studied.

Objective: We sought to investigate whether patients with psoriasis have an increased risk of arrhythmia.

Methods: This population-based cohort study identified 40,637 patients with psoriasis and 162,548 subjects without psoriasis matched by age, sex, history of coronary artery disease, hypertension, and diabetes in the Taiwan National Health Insurance Research Database during 2004 through 2006.

Results: After adjusting for medical history and medication use, patients with psoriasis were at increased risk of overall arrhythmia (adjusted hazard ratio [aHR] 1.34; 95% confidence interval [CI] 1.29-1.39). The risks of arrhythmia were higher in all subgroups, including patients with severe (aHR 1.25; 95% CI 1.12-1.39) and mild (aHR 1.35; 95% CI 1.30-1.41) psoriasis, and in patients with (aHR 1.46; 95% CI 1.22-1.74) and without (aHR 1.33; 95% CI 1.28-1.39) psoriatic arthritis.

Limitations: The National Health Insurance Research Database did not contain information regarding Psoriasis Area and Severity Index, cigarette smoking, or alcohol consumption.

Conclusion: Patients with psoriasis were at higher risk of developing arrhythmia, particularly for those with psoriatic arthritis, independent of traditional cardiovascular risk factors.

Keywords: National Health Insurance Research Database; arrhythmia; cardiovascular diseases; ischemic heart disease; psoriasis; psoriatic arthritis; stroke.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / etiology*
  • Arrhythmias, Cardiac / physiopathology
  • Arthritis, Psoriatic / complications*
  • Arthritis, Psoriatic / diagnosis
  • Arthritis, Psoriatic / drug therapy
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Case-Control Studies
  • Confidence Intervals
  • Databases, Factual
  • Electrocardiography / methods
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Psoriasis / complications*
  • Psoriasis / diagnosis
  • Psoriasis / drug therapy
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Survival Rate
  • Taiwan