Elevated Atherosclerotic Cardiovascular Disease Risk in Fibrotic Skin Diseases: Insights From a TriNetX Cohort Study

J Drugs Dermatol. 2025 Nov 1;24(11):1121-1125. doi: 10.36849/JDD.8991.

Abstract

Background: Identifying the risk of atherosclerotic cardiovascular disease (ASCVD) is a cornerstone of preventive medical care. Despite its significance, limited research has explored ASCVD risk in individuals with fibrotic skin diseases. This study aims to evaluate the risk of ASCVD in patients diagnosed with fibrotic skin conditions.

Methods: We utilized the TriNetX platform to analyze ASCVD risk associated with fibrotic skin conditions. Propensity score-matched (PSM) cohorts were constructed to adjust for confounding. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression.

Results: Patients with fibrotic skin diseases demonstrated an elevated risk of ASCVD. Scleroderma was most strongly associated with ASCVD risk (HR 2.51 [95% CI: 1.97,3.21]), followed by hypertrophic scar (HR 1.40 [95% CI: 1.20,1.63]). Elevated risks were also observed for morphea (HR 1.36 [95% CI: 1.03,1.08]) and lichen sclerosis (HR 1.30 [95% CI: 1.04,1.62]).

Conclusion: Individuals with fibrotic skin conditions, including scleroderma, hypertrophic scars, morphea, and lichen sclerosis, demonstrate an increased risk of ASCVD. These findings highlight the significance of recognizing fibrotic skin diseases as possible indicators of systemic inflammation.

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / etiology
  • Cicatrix, Hypertrophic / complications
  • Cicatrix, Hypertrophic / epidemiology
  • Cohort Studies
  • Female
  • Fibrosis
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Proportional Hazards Models
  • Risk Assessment
  • Risk Factors
  • Skin / pathology
  • Skin Diseases* / complications
  • Skin Diseases* / epidemiology