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Open Access Research article

Prognosis after percutaneous coronary intervention in patients with psoriasis: a cohort study using Danish nationwide registries

Ole Ahlehoff12*, Jesper Lindhardsen1, Gunnar H Gislason1, Jonas B Olesen1, Mette Charlot1, Lone Skov3, Christian Torp-Pedersen1 and Peter R Hansen1

Author Affiliations

1 Department of Cardiology, Copenhagen University Hospital, Gentofte, Hellerup DK-2900, Denmark

2 Department of Cardiology, Copenhagen University Hospital, Roskilde, Roskilde DK-4000, Denmark

3 Department of Dermatology, Copenhagen University Hospital, Gentofte, Hellerup DK-2900, Denmark

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BMC Cardiovascular Disorders 2012, 12:79  doi:10.1186/1471-2261-12-79

Published: 24 September 2012

Abstract

Background

Psoriasis is an inflammatory disease associated with increased risk of coronary artery disease. However, the potential impact of psoriasis on the prognosis following percutaneous coronary revascularization (PCI) is unknown.

Methods

The study comprised the entire Danish population undergoing first-time PCI in the period 2002–09. Cox regression models, controlling for age, gender, socioeconomic status, pharmacological treatment, and comorbidity were used to assess the risk of 1) all-cause mortality and 2) a composite endpoint of death, myocardial infarction, and stroke.

Results

A total of 53,141 patients with first-time PCI in the study period were identified. Of these, 1074 had mild psoriasis and 315 had severe psoriasis. Patients with severe psoriasis, but not those with mild disease had increased risk of both endpoints compared to patients without psoriasis. The incidence rates for all-cause mortality were 30.5 (CI 29.7-31.3), 29.9 (CI 24.7-36.1), and 47.2 (CI 35.0-63.6) per 1000 patient years for patients without psoriasis, with mild psoriasis, and with severe psoriasis, respectively. Hazard ratios were 1.10 (CI 0.91-1.33) and 1.67 (CI 1.24-2.26) for mild and severe psoriasis, respectively. Patients with severe psoriasis were less likely to receive secondary prevention pharmacotherapy with betablockers, statins and platelet inhibitors.

Conclusion

This first study of the prognosis following PCI in patients with psoriasis demonstrated an increased risk of all-cause mortality and of a composite of death, myocardial infarction and stroke, respectively, in patients with severe psoriasis compared to patients without psoriasis. Further studies of this novel association are needed.

Keywords:
Coronary revascularization; Cardiovascular disease; Inflammation; Psoriasis; Prognosis