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Increased risk of arrhythmia in patients with psoriatic disease: A nationwide population-based matched cohort study - 17/08/15

Doi : 10.1016/j.jaad.2015.06.023 
Hsien-Yi Chiu, MD a, b, c, d, Wei-Lun Chang, MS e, Weng-Foung Huang, PhD e, Yu-Wen Wen, PhD f, Yi-Wen Tsai, PhD e, Tsen-Fang Tsai, MD d,
a Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan 
b Department of Dermatology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan 
c Department of Dermatology, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan 
d Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan 
e Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan 
f Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Tao-Yuan, Taiwan 

Reprint requests: Tsen-Fang Tsai, MD, Department of Dermatology, National Taiwan University Hospital, No. 7 Chung San South Road, Taipei 100, Taiwan.

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.

Le texte complet de cet article est disponible en PDF.

Key words : arrhythmia, cardiovascular diseases, ischemic heart disease, National Health Insurance Research Database, psoriasis, psoriatic arthritis, stroke

Abbreviations used : aHR, CI, ECG, HR, ICD-9-CM, IL, NHI, NHIRD, PsA


Plan


 The first two authors contributed equally to this article.
 This work was supported by a grant from National Taiwan University Hospital Hsin-Chu Branch (HCH104-021), but had no other study sponsors. The researchers were independent of the funders in designing the study, data collection and analysis, interpreting the results, writing the manuscript, and deciding to submit the article for publication.
 Disclosure: All authors have completed the International Committee of Medical Journal Editors uniform disclosure form at coi_disclosure.pdf and declare that: Dr Tsen-Fang Tsai has conducted clinical trials or received honoraria for serving as a consultant for Pfizer Pharmaceuticals, Serono International SA (now Merck Serono International), UniPharma/Biogen Idec, Galderma, Celgene, Novartis Pharmaceuticals, and Janssen-Cilag Pharmaceutical, and has received speaking fees from AbbVie. Drs Chiu, Huang, Wen, and Yi-Wen Tsai, and Ms Chang have no conflicts of interest to declare.
 This study is based in part on data from the National Health Insurance Research Database provided by the National Health Insurance Administration, Ministry of Health and Welfare, and managed by National Health Research Institutes. The interpretation and conclusions contained herein do not represent those of the National Health Insurance Administration, Ministry of Health and Welfare, or National Health Research Institutes.


© 2015  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 73 - N° 3

P. 429-438 - septembre 2015 Retour au numéro
Article précédent Article précédent
  • To test or not to test? An updated evidence-based assessment of the value of screening and monitoring tests when using systemic biologic agents to treat psoriasis and psoriatic arthritis
  • Christine S. Ahn, Emily H. Dothard, Michael L. Garner, Steven R. Feldman, William W. Huang
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  • Azathioprine treatment of intractable pruritus: A retrospective review
  • Alexander Maley, Robert A. Swerlick

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