Association between hidradenitis suppurativa and peripheral arterial occlusion disease: a propensity-score-matched cohort study

Abstract

Background: There are plausible mechanistic associations between hidradenitis suppurativa (HS) and peripheral arterial occlusive disease (PAOD), which has significant clinical implications.

Objectives: This study investigated the risk of incident PAOD in patients with HS.

Methods: A retrospective cohort study using the TriNetX research network was conducted. Patients with HS were matched 1 : 1 with an HS-free control group based on demographic and clinical factors. The primary outcome was the incidence of PAOD, analysed using hazard ratios (HRs) and Kaplan-Meier curves over a 15-year follow-up period. Sensitivity and stratification analyses were performed to validate the findings.

Results: Over a 15-year follow-up, patients with HS demonstrated a significantly higher risk of developing PAOD compared with matched patients without HS (HR 1.23, 95% CI 1.16-1.30) in the crude model. This risk persisted after adjusting for possible confounders. Kaplan-Meier analysis showed a higher cumulative probability of PAOD in the HS cohort (adjusted HR 1.48, 95% CI 1.36-1.61, log-rank P-value of < 0.01) over the entire follow-up period. Sensitivity analyses confirmed the robustness of these findings across various models. Stratification analyses indicated a consistent PAOD risk across sex and age subgroups, with higher risks observed in men (HR 1.79, 95% CI 1.54-2.09) and patients aged ≥ 65 years (HR 1.77, 95% CI 1.53-2.04).

Conclusions: HS is associated with an increased risk of PAOD, independent of traditional cardiovascular risk factors. These findings underscore the importance of cardiovascular risk assessment and management in patients with HS. Further research is needed to elucidate the underlying mechanisms and evaluate the impact of HS treatment on PAOD risk.