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Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack : an inception cohort study with a nested case-control analysis

Brauchli, Y. B. and Jick, S. S. and Miret, M. and Meier, C. R.. (2009) Psoriasis and risk of incident myocardial infarction, stroke or transient ischaemic attack : an inception cohort study with a nested case-control analysis. British journal of dermatology, Vol. 160, H. 5. pp. 1048-1056.

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Official URL: http://edoc.unibas.ch/dok/A5255155

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Abstract

BACKGROUND: Systemic inflammation may increase the risk for cardiovascular diseases in patients with psoriasis, but data on this risk in patients with early psoriasis are scarce. OBJECTIVES: To assess and compare the risk of developing incident myocardial infarction (MI), stroke or transient ischaemic attack (TIA) between an inception cohort of patients with psoriasis and a psoriasis-free population. METHODS: We conducted an inception cohort study with a nested case-control analysis within the U.K.-based General Practice Research Database. The study population encompassed 36,702 patients with a first-time recorded diagnosis of psoriasis 1994-2005, matched 1 : 1 to psoriasis-free patients. We assessed crude incidence rates (IRs) and applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Overall, the IRs of MI (n = 449), stroke (n = 535) and TIA (n = 402) were similar among patients with or without psoriasis. However, the adjusted OR of developing MI for patients with psoriasis aged > 60 years was 1.66 (95% CI 1.03-2.66) compared with patients without psoriasis, while the OR for patients aged <or= 60 years was 0.99 (95% CI 0.77-1.26). The adjusted ORs of developing MI for patients of all ages with 2 prescriptions/year for oral psoriasis treatment were 2.48 (95% CI 0.69-8.91) and 1.39 (95% CI 0.43-4.53), with a similar finding for stroke and TIA. CONCLUSIONS: The risk of developing a cardiovascular outcome was not materially elevated for patients with early psoriasis overall. In subanalyses, however, there was a suggestion of an increased (but low absolute) MI risk for patients with psoriasis aged > 60 years, mainly with severe disease.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Klinische Pharmakologie > Klinische Pharmakologie (Krähenbühl)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Klinische Pharmakologie > Klinische Pharmakologie (Krähenbühl)
05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Pharmazie > Klinische Pharmazie/Spitalpharmazie (Meier)
UniBasel Contributors:Meier, Christoph R.
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Lewis
ISSN:0007-0963
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:05
Deposited On:22 Mar 2012 13:35

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