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Inicio Medicina Clínica (English Edition) Mortality in patients with psoriasis. A retrospective cohort study
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Vol. 148. Issue 11.
Pages 483-488 (June 2017)
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Vol. 148. Issue 11.
Pages 483-488 (June 2017)
Original article
DOI: 10.1016/j.medcle.2017.05.005
Mortality in patients with psoriasis. A retrospective cohort study
Mortalidad en pacientes con psoriasis. Análisis de una cohorte retrospectiva
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Walter Masson
Corresponding author
, Emiliano Rossi, María Laura Galimberti, Juan Krauss, José Navarro Estrada, Ricardo Galimberti, Arturo Cagide
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Table 1. Prevalence of traditional vascular risk factors in the total population and in the groups with or without psoriasis.
Table 2. Cox regression model showing effect on mortality of different vascular risk factors and psoriasis.
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Abstract
Background and objectives

The immune and inflammatory pathways involved in psoriasis could favour the development of atherosclerosis, consequently increasing mortality. The objectives of this study were: (1) to assess the mortality of a population with psoriasis compared to a control group, and (2) to assess the prevalence of cardiovascular risk factors.

Patients and method

A retrospective cohort was analyzed from a secondary database (electronic medical record). All patients with a diagnosis of psoriasis at 1-01-2010 were included in the study and compared to a control group of the same health system, selected randomly (1:1). Subjects with a history of cardiovascular disease were excluded from the study. A survival analysis was performed considering death from any cause as an event. Follow-up was extended until 30-06-2015.

Results

We included 1481 subjects with psoriasis and 1500 controls. Prevalence of cardiovascular risk factors was higher in the group with psoriasis. The average follow-up time was 4.6±1.7 years. Mortality was higher in psoriasis patients compared to controls (15.1 vs. 9.6 events per 1000 person-year, p<.005). Psoriasis was seen to be significantly associated with increased mortality rates compared to the control group in the univariate analysis (HR 1.58, 95% CI 1.16–2.15, p=.004) and after adjusting for cardiovascular risk factors (HR 1.48, 95% CI 1.08–2.3, p=.014).

Conclusion

In this population, patients with psoriasis showed a higher prevalence for the onset of cardiovascular risk factors as well as higher mortality rates during follow-up.

Keywords:
Psoriasis
Cardiovascular risk factors
Mortality
Resumen
Fundamentos y objetivos

Las modificaciones inmunológicas e inflamatorias observadas en la psoriasis podrían favorecer el desarrollo de la aterosclerosis, aumentando consecuentemente la mortalidad. Los objetivos fueron: 1) determinar la mortalidad de una población con psoriasis en comparación con un grupo control, y 2) conocer la prevalencia de los factores de riesgo cardiovascular.

Pacientes y método

Se analizó una cohorte retrospectiva a partir de una base de datos secundaria (historia clínica electrónica). Se incluyeron todos los pacientes con diagnóstico de psoriasis a 1-01-2010, comparándolos con un grupo control del mismo sistema de salud, seleccionados de forma aleatoria (relación 1:1). Se excluyeron los sujetos con antecedentes cardiovasculares. Se realizó un análisis de sobrevida, determinando como episodio la muerte por cualquier causa. El seguimiento se extendió hasta el 30-6-2015.

Resultados

Se analizaron 1.481 pacientes con psoriasis y 1.500 controles. La prevalencia de los factores de riesgo cardiovascular fue más elevada en el grupo con psoriasis. El tiempo promedio de seguimiento fue de 4,6±1,7 años. La mortalidad fue mayor en los psoriásicos en comparación con los controles (15,1 frente a 9,6 episodios cada 1.000 personas-año, p<0,005). La psoriasis se asoció significativamente con una mayor mortalidad en comparación con el grupo control en el análisis univariado (HR 1,58, IC 95% 1,16-2,15, p=0,004) y luego de ajustar por los factores de riesgo cardiovascular (HR 1,48, IC 95% 1,08-2,3, p=0,014).

Conclusión

En esta población, los pacientes con psoriasis mostraron una mayor prevalencia de factores de riesgo cardiovascular en el momento del diagnóstico y una mayor mortalidad en el seguimiento.

Palabras clave:
Psoriasis
Factores de riesgo cardiovascular
Mortalidad

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