Psoriasis and risk of atrial fibrillation and ischaemic stroke: a Danish Nationwide Cohort Study

Psoriasis is a chronic inflammatory disease and inflammation contributes to the pathogenesis of atrial fibrillation (AF) and ischaemic stroke. We therefore investigated the risk of these endpoints in patients with psoriasis. Cohort study of the entire Danish population followed from 1997 to 2006 by individual-level-linkage of nationwide prospectively recorded registers. Multivariable Poissons regression and sensitivity analyses were used to assess the psoriasis-related risk of AF and ischaemic stroke. A total of 36 765 patients with mild psoriasis and 2793 with severe psoriasis were compared with 4 478 926 individuals, i.e. the reference population. In patients with mild psoriasis, the adjusted rate ratios (RRs) for AF were 1.50 (1.211.86) and 1.16 (1.081.24) in patients aged 50 and epsilon 50 years, respectively. Patients with severe psoriasis had a higher risk of AF with RRs 2.98 (1.804.92) in patients aged 50 years and 1.29 (1.011.65) in patients aged epsilon 50 years. Patients with psoriasis also demonstrated a disease severity-dependent increased risk of ischaemic stroke, i.e. RRs 1.97 (1.662.34) and 2.80 (1.814.34) in patients aged 50 years with mild and severe psoriasis, and RRs 1.13 (1.041.21) and 1.34 (1.041.71) in patients aged epsilon 50 years with mild and severe psoriasis, respectively. A range of sensitivity analyses yielded comparable results. Psoriasis is associated with increased risk of AF and ischaemic stroke. These novel results add to a growing body of evidence, suggesting that patients with psoriasis could be considered at increased cardiovascular risk.