Psoriasis Severity Linked to Risk of Abdominal Aortic Aneurysm

In a nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of abdominal aortic aneurysm (AAA), according to a new study.

Although limited case series have reported an increased risk of AAA in some other autoimmune disorders, including rheumatoid arthritis and systemic lupus erythematosus, no large-scale studies have explored the potential association between AAA and psoriasis, the researchers said.
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The study comprised all Danish residents aged ≥18 years followed up from Jan. 1, 1997, until diagnosis of AAA, Dec. 31, 2011, migration, or death. They identified Information on comorbidity, concomitant medication, and socioeconomic status by individual-level linkage of administrative registers. Investigators calculated incidence rates for AAA, and incidence rate ratios adjusted for age, sex, comorbidity, medications, socioeconomic status, and smoking were estimated in Poisson regression models.

During the study period, they identified 59,423 patients with mild psoriasis and 11,566 patients with severe psoriasis. The overall incidence rates of AAA were 3.72, 7.30, and 9.87 per 10,000 person-years for the reference population (23,696 cases), mild psoriasis (240 cases), and severe psoriasis (50 cases), respectively.

The corresponding adjusted incidence rate ratios for AAA were increased in patients with psoriasis with incidence rate ratios of 1.20 (95% confidence interval, 1.03-1.39) and 1.67 (95% confidence interval, 1.21-2.32) for subjects with mild and severe disease, respectively.

"At present, we do not know how and why this link occurs, but we know it is there, and therefore patients who have psoriasis should be educated to know their risk of cardiovascular comorbidities and should get a regular assessment of the risk factors,” said lead study author Usman Khalid, MD, PhD, Department of Cardiology, Gentofte Hospital, Denmark. “Several studies have shown that body inflammation decreases when the cardiovascular risk factors such as blood glucose levels, lipid levels, and smoking, are effectively controlled for." 

-Mike Bederka

Reference:

Khalid U, Egeberg A, Ahlehoff O, et al. Nationwide study on the risk of abdominal aortic aneurysms in patients with psoriasis [published online April 14, 2016]. Arterioscler Thromb Vasc Biol. doi:10.1161/ATVBAHA.116.307449.