title: Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint study.
abstract: BACKGROUND
  Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH).
  
  
  METHODS
  The predictive value of baseline or incident psoriasis for new-onset atrial fibrillation was evaluated in 7099 hypertensive patients with electrocardiographic LVH with no history of atrial fibrillation or other cardiovascular disease, in sinus rhythm on their baseline electrocardiogram.
  
  
  RESULTS
  A total of 154 patients (2.2%) had or developed psoriasis and new-onset atrial fibrillation occurred in 506 patients (7.1%) during a mean follow-up of 4.7 ± 1.1 years. At baseline, the psoriasis patients were younger (65 ± 7 vs. 67 ± 7 years) and had less left ventricle hypertrophy by ECG Sokolow-Lyon voltage (27.6 ± 9.7 vs. 30.1 ± 10.4 mm); higher hemoglobin (6.3 ± 2.2 vs. 6.0 ± 2.7 mmol/l) and prevalence of diabetes (20.6 vs. 12.8%, P ≤ 0.004) than patients without psoriasis. In multivariable Cox analysis, adjusting for age, sex, hemoglobin, diabetes, time-varying SBP, heart rate, study treatment and Sokolow-Lyon hypertrophy, psoriasis, treated as a time-varying covariate, was associated with a two-fold higher risk of new-onset atrial fibrillation [hazard ratio: 1.97 (95% confidence interval (CI): 1.18-3.30), P=0.01]. Propensity-matched analysis yielded similar results (odds ratio: 3.49, 95% CI 1.24-9.81, P=0.018).
  
  
  CONCLUSIONS
  Psoriasis has a similar prevalence in hypertensive patients as in the general population. Psoriasis independently predicted new-onset atrial fibrillation despite lower age and electrocardiographic LVH in psoriasis patients than in patients without psoriasis.
authors.affiliation: aDepartment of Medicine, Weill Cornell Medical College, New York, New York, USA bDepartment of Cardiology, The Heart Center, Rigshospitalet, Copenhagen cDepartment of Medicine, Glostrup University Hospital, Glostrup, Denmark dDepartment of Dermatology, Tuffs Medical Center, Boston, Massachusetts, USA.
authors.forename: Casper N
authors.initials: CN
authors.lastname: Bang
authors.forename: Peter M
authors.initials: PM
authors.lastname: Okin
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Kristian
authors.initials: K
authors.lastname: Wachtell
authors.forename: Alice Bendix
authors.initials: AB
authors.lastname: Gottlieb
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000188:drug therapy*; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000150:complications*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D019808:Losartan