title: Psoriasis and risk of heart failure: a nationwide cohort study.
abstract: OBJECTIVE
  Psoriasis is a common inflammatory disease that is associated with increased risk of cardiovascular disease, including myocardial infarction. Heart failure (HF) is independently associated with several cardiovascular risk factors and is a major cause of cardiovascular morbidity and mortality. The association between psoriasis and HF is unclear and we therefore investigated the risk of new-onset HF in a nationwide cohort of psoriasis patients compared with the background population.
  
  
  METHODS
  The study included the entire Danish population aged ≥18 years followed from 1 January 1997 until HF, death or 31 December 2011. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. New-onset HF was defined as first hospital admission for HF. Incidence rates of new-onset HF were calculated and adjusted hazard ratios were estimated by multivariable Cox regression models adjusted for age, gender, comorbidity and cardiovascular medications.
  
  
  RESULTS
  A total of 5 485 856 subjects were eligible for analysis. In the study period 66 389 patients with new-onset psoriasis, including 11 242 patients with severe psoriasis, were identified. The overall incidence rates of new-onset HF were 2.82, 4.22 and 4.70 per 1000 person-years for the reference population, mild psoriasis and severe psoriasis, respectively. Compared with the reference population, the fully adjusted hazard ratios for new-onset HF were increased in patients with psoriasis with a hazard ratio 1.22 (95% confidence interval 1.16-1.29) and hazard ratio of 1.53 (95% confidence interval 1.34-1.74) for those with mild and severe disease, respectively.
  
  
  CONCLUSIONS
  In this nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of new-onset HF.
authors.affiliation: Department of Cardiology, Gentofte Hospital University of Copenhagen, Hellerup.
authors.forename: Usman
authors.initials: U
authors.lastname: Khalid
authors.forename: Ole
authors.initials: O
authors.lastname: Ahlehoff
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
authors.forename: Søren Lund
authors.initials: SL
authors.lastname: Kristensen
authors.forename: Lone
authors.initials: L
authors.lastname: Skov
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.forename: Peter Riis
authors.initials: PR
authors.lastname: Hansen
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000453:epidemiology; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006333:Heart Failure / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011565:Psoriasis / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents; D002317:Cardiovascular Agents
keywords: Cardiovascular risk; Epidemiology; Heart failure; Inflammation; Psoriasis