Psoriasis and psoriatic arthritis have long been associated with cardiovascular disease and deaths, but now a large population study from Taiwan indicates the danger of cardiac arrhythmias is increased independently of traditional risk factors such as coronary disease and high blood pressure.
Psoriasis and psoriatic arthritis (PsA) have long been associated with cardiovascular disease (CVD) and deaths, but now a large population study from Taiwan indicates the danger of cardiac arrhythmias is increased independently of traditional risk factors such as coronary disease and high blood pressure. The study, published in the July 15, 2015 issue of the Journal of the American Academy of Dermatology, looks at the medical records of 40,637 patients with psoriatic disease (including PsA) and 162,548 controls matched by age, sex, history of coronary artery disease (CAD), hypertension and diabetes in the Taiwan National Health Insurance Research Database. “Despite several risk factors associated with arrhythmia known to be more prevalent in patients with psoriasis, there is scarcity of data on heart rhythm abnormalities in these patients. Moreover, those few published data on this topic are derived from small studies involving predominantly Caucasian subjects, making it uncertain whether the finding can be extrapolated to other ethnicities, such as Asian.13 We therefore assessed the risk of arrhythmia in a large nationally representative, population-based cohort of Chinese patients with psoriasis from Taiwan,” the researchers wrote.
SUMMARY
Psoriasis is associated with cardiovascular risk factors and a higher mortality as a result of cardiovascular diseases.
Patients with psoriasis had a higher risk of arrhythmia compared with the general population, independent of classic cardiovascular risk.
This study encourages clinicians to include assessments of arrhythmia during psoriasis treatment.
Source: JAAD
The study shows that patients with psoriatic disease -- especially those with PsA -- have a 34% increased risk of arrhythmia compared with those without psoriasis. Other studies show severe psoriasis is associated with an almost 60% risk of adverse cardiac events and death beyond that linked to traditional risk factors. The researchers, led by Tsen-Fang Tsai, MD, of the National Taiwan University Hospital, speculate that the chronic skin inflammation associated with psoriatic disease also leads to vascular inflammation which may alter the conductive properties of heart muscle and trigger arrhythmias. In particular, they say, psoriasis carries a greater risk for paroxysmal supraventricular tachycardia. A limitation of the study is risk of arrhythmias is estimated based on secondary claims data, rather than on electrocardiogram records. However, the researchers urge that patients with psoriatic disease and PsA be monitored for cardiac rhythm abnormalities during treatment for their disease.
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