title: Increased risk of aortic valve stenosis in patients with psoriasis: a nationwide cohort study.
abstract: OBJECTIVE
  Psoriasis is a chronic inflammatory disease associated with increased risk of cardiovascular disease including atherosclerosis. The pathogenesis of aortic valve stenosis (AS) also includes an inflammatory component. We therefore investigated the risk of AS in patients with psoriasis compared with the general population in a nationwide cohort.
  
  
  METHODS
  The study comprised the entire Danish population aged ≥18 years followed from 1 January 1997 until diagnosis of AS, 31 December 2011, or death. Information on comorbidity, concomitant medication, and socioeconomic status was identified by individual-level linkage of administrative registers. Incidence rates for AS were calculated and incidence rate ratios (IRRs) adjusted for age, gender, calendar year, comorbidity, medications, and socioeconomic status, were estimated in Poisson regression models.
  
  
  RESULTS
  A total of 5 107 624 subjects were eligible for analysis. During the study period, we identified 58 747 patients with mild psoriasis and 11 918 patients with severe psoriasis. The overall incidence rates for AS were 8.09, 16.07, and 20.08 per 10 000 person-years for the reference population (48 539 cases [mean follow-up 12.3 years]), mild psoriasis (509 cases [mean follow-up 6.2 years]), and severe psoriasis (99 cases [mean follow-up 5.4 years]), respectively. Correspondingly, the fully adjusted IRRs for AS were markedly increased in patients with psoriasis with IRR 1.22 (95% confidence interval [CI] 1.12-1.33) and IRR 1.61 (CI 1.32-1.96) for subjects with mild and severe disease, respectively.
  
  
  CONCLUSIONS
  In a nationwide cohort, psoriasis was associated with a disease severity-dependent increased risk of AS. The mechanisms underlying this novel finding require further study.
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Post 635, Niels Andersens Vej 65, Hellerup DK-2900, Denmark usman.khalid@regionh.dk.
authors.forename: Usman
authors.initials: U
authors.lastname: Khalid
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Post 635, Niels Andersens Vej 65, Hellerup DK-2900, Denmark Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Ahlehoff
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Post 635, Niels Andersens Vej 65, Hellerup DK-2900, Denmark National Institute of Public Health, University of Southren Denmark, Copenhagen, Denmark Faculty of Health Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark.
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Faculty of Health Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark Department of Dermatology, Gentofte Hospital, University of Copenhagen, Hellerup DK-2900, Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Skov
authors.affiliation: Faculty of Health Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark Science and Technology, Institute of Health, Aalborg University, Aalborg, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Post 635, Niels Andersens Vej 65, Hellerup DK-2900, Denmark Faculty of Health Sciences, University of Copenhagen, Copenhagen DK-2200, Denmark.
authors.forename: Peter Riis
authors.initials: PR
authors.lastname: Hansen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000453:epidemiology / Q000209:etiology*; D003718:Denmark / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications* / Q000453:epidemiology; D017678:Sex Distribution; D055815:Young Adult
keywords: Aortic valve stenosis; Cardiovascular risk; Epidemiology; Inflammation; Psoriasis