Author Interview: Ole Ahlehoff MD, PhD
Article: Prognosis following first-time myocardial infarction in patients with psoriasis: a Danish nationwide cohort study.
Department of Cardiology
Copenhagen University Hospital Gentofte DK-2900 Denmark
What are the main findings of the study?
OA: Psoriasis has previously been linked to increased risks of cardiovascular diseases, e.g., myocardial infarction (MI) and stroke. However, the potential impact of psoriasis on the prognosis after MI has not been examined before. The present study of all Danish citizens suffering a first-time MI in the period 2002-06 (approx. 50.000 patients including 462 patients with psoriasis) demonstrated that patients with psoriasis face a poorer prognosis, including increased death rates, compared to patients without psoriasis.
The incidence rates per 1000 patient years for all-cause deaths were 16 per cent higher for those with psoriasis (138.3 versus 119.4) and the adjusted hazard ratio was 1.18 (18 per cent higher).
The incidence rates per 1000 patient years for deaths for a composite of cardiovascular death, recurrent MI or stroke were 24 per cent higher for those with psoriasis (185.6 versus 149.7) and the adjusted hazard ratio was 1.26 (26 per cent higher).
What should clinicians and patients take away from this study?
OA: These novel findings add to current evidence incriminating psoriasis as an important contributor to cardiovascular morbidity and mortality. The results stress the importance of adequate cardiovascular secondary prophylaxis following a MI.
What recommendations do you have for cardiology health care providers as a result of your study?
OA: Patients with psoriasis should be considered a high risk population in terms of cardiovascular risks. All patients are candidates for interventions aimed at healthy lifestyle. Patients with severe psoriasis may be candidates for pharmacological risk factor modification, e.g. blood pressure reduction and cholesterol lowering therapy.
Importantly, patients with psoriasis may be candidates for more aggressive cardiovascular secondary prophylaxis following a MI.
Reference:
Prognosis following first-time myocardial infarction in patients with psoriasis: a Danish nationwide cohort study.
Ahlehoff, O., Gislason, G. H., Lindhardsen, J., Olesen, J. B., Charlot, M., Skov, L., Torp-Pedersen, C. and Hansen, P. R. (2011),
Journal of Internal Medicine, 270: 237–244. doi: 10.1111/j.1365-2796.2011.02368.x
