title: Prognosis following first-time myocardial infarction in patients with psoriasis: a Danish nationwide cohort study.
abstract: OBJECTIVE
  The magnitude of cardiovascular risk associated with psoriasis has been debated and the prognostic impact of psoriasis following myocardial infarction (MI) is unknown. Therefore, we investigated the risk of mortality and adverse cardiovascular events in patients with psoriasis following first-time MI.
  
  
  METHODS
  Cohort study of the entire Danish population including all individuals who experienced first-time MI during the period 2002-2006. Multivariable Cox regression models were used to assess the post-MI prognostic impact of psoriasis. Main outcome measures.  All-cause mortality and a composite cardiovascular end-point of recurrent MI, stroke and cardiovascular death.
  
  
  RESULTS
  A total of 462 patients with psoriasis and 48 935 controls (mean age 69.5 and 70.6 years, respectively) were identified with first-time MI during the study period. The mean follow-up was 19.5 months [standard deviation (SD) 16.5] for patients with psoriasis and 22 .0 months (SD 18.7) for those without psoriasis. Incidence rates (IRs) per 1000 patient-years for all-cause mortality were 119.4 [95% confidence interval (CI) 117.2-138.3] and 138.3 (95% CI 114.1-167.7) for patients without and with psoriasis, respectively, and the adjusted hazard ratio (HR) associated with psoriasis was 1.18 (95% CI 0.97-1.43). For the composite end-point, the IRs were 149.7 (95% CI 147.1-152.4) and 185.6 (95% CI 155.8-221.0) for patients without and with psoriasis, respectively, with an HR of 1.26 (95% CI 1.04-1.54) for patients with psoriasis.
  
  
  CONCLUSIONS
  This first study of the impact of psoriasis on prognosis after first-time MI indicated a significantly impaired prognosis in patients with psoriasis. Further studies of this novel association are warranted.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. olahha01@geh.regionh.dk
authors.forename: O
authors.initials: O
authors.lastname: Ahlehoff
authors.forename: G H
authors.initials: GH
authors.lastname: Gislason
authors.forename: J
authors.initials: J
authors.lastname: Lindhardsen
authors.forename: J B
authors.initials: JB
authors.lastname: Olesen
authors.forename: M
authors.initials: M
authors.lastname: Charlot
authors.forename: L
authors.initials: L
authors.lastname: Skov
authors.forename: C
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: P R
authors.initials: PR
authors.lastname: Hansen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D009204:Myocardial Revascularization; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications / Q000453:epidemiology*; D012008:Recurrence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology
chemical_list: D002317:Cardiovascular Agents