No Association Found Between Hives and Heart Attack

A Danish study showed no increased incidence of heart disease in patients treated for chronic urticaria, despite the skin condition’s established association with other cardiac risk precursors.

Alexander Egeberg, MD, PhD, and colleagues from the University of Copenhagen collated nationwide hospital and medicinal product data on 2,215 adults with chronic urticaria (CU) and 977 diagnosed with inducible CU (CIndU). A total of 30 healthy control subjects were identified from the general population matched by sex and age to each subject in the two groups totaling 66,203 CU controls and 28,497 CIndU.

Patient data were analyzed for a risk of myocardial infarction (MI), ischemic stroke, cardiovascular (CV) death, and major adverse cardiovascular events (MACE: a composite of MI, ischemic stroke, and CV death).

Despite known correlation between CU and autoimmune diseases and recent findings pointing to increased risk of metabolic syndrome, obesity, and hyperlipidemia in cases of CU, Egeberg said: “Incidence rates were generally comparable between cases and controls, and after adjustment for potential confounding factors, there was no significantly increased risk of MI, ischemic stroke, CV death or MACE”.

Cases were followed until migration, death, or endpoint, which were diagnoses of MI, ischemic stroke, CV death, and MACE, respectively.

Baseline treatment up to six months before study inclusion was defined for azathioprine, cholesterol lowering drugs, cyclosporine, methotrexate, montelukast, and omalizumab. Baseline comorbidity was assessed up to five years prior to study inclusion for alcohol abuse, cardiovascular disease, diabetes, and hypertension.

Incidence rates were summarized per 1,000 person-years, and Cox regression analyses were performed to estimate crude and fully adjusted (adjusted for age, sex, socio-economic status, medication, and comorbidity) hazard ratios (HRs), respectively. The team tested model assumptions and found to be valid; the p < .05 was considered significant and results were reported with 95% confidence intervals (CIs) where applicable.

All analyses were performed using SAS v9.4 and STATA v13.0. Presentation of data on less than three individuals is not permitted, thus results of one or two events or individuals are shown as < 3.

The paper, "Cardiovascular Risk is not Increased in Patients with Chronic Urticaria: A Retrospective Population-based Cohort Study," was published online by Sweden’s Acta Dermato-Venereologica.

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