title: Risk and predictors of cardiovascular disease in psoriasis: a population-based study.
abstract: BACKGROUND
  Emerging evidence suggests that severe psoriasis is associated with increased risk of cardiovascular disease. The goal of this study was to examine the risk and predictors of clinical cardiovascular events in psoriasis.
  
  
  METHODS
  We performed a historical cohort and a nested case-cohort study using the population-based resources in Olmsted County, Minnesota. The study population included a population-based incidence cohort of patients with psoriasis first diagnosed between January 1, 1970, and January 1, 2000, and 2678 age- and sex-matched non-psoriasis subjects. Cardiovascular events, including hospitalized myocardial infarction, coronary revascularization procedures, stroke, heart failure, and cardiovascular death.
  
  
  RESULTS
  Psoriasis was associated with an increased risk of myocardial infarction based on diagnostic codes (hazard ratio 1.26; 95% confidence intervals: 1.01, 1.58) but not when the analyses were restricted to validated myocardial infarction (hazard ratio 1.18; 95% confidence intervals: 0.80, 1.74). Psoriasis was not associated with an increased risk of heart failure or cardiovascular death. Traditional cardiovascular risk factors were significantly associated with cardiovascular risk in psoriasis. Each 1% increase in Framingham risk score at psoriasis incidence corresponded with a 5-10% increase in risk of cardiovascular events.
  
  
  CONCLUSIONS
  In this large incidence cohort of patients with psoriasis representing the full disease severity spectrum, psoriasis was not associated with an increased cardiovascular risk.
authors.affiliation: Department of Health Sciences, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA. maradit@mayo.edu
authors.forename: Hilal
authors.initials: H
authors.lastname: Maradit-Kremers
authors.forename: Ross A
authors.initials: RA
authors.lastname: Dierkhising
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.forename: Murat
authors.initials: M
authors.lastname: Icen
authors.forename: Floranne C
authors.initials: FC
authors.lastname: Ernste
authors.forename: Marian T
authors.initials: MT
authors.lastname: McEvoy
mesh_terms: D000367:Age Factors; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011565:Psoriasis / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors