A recently published literature review and meta-analysis suggests that cardiovascular disease and psoriasis may share the same genetic origin, and that cardiovascular outcomes may be improved with targeted psoriasis therapy.
“Psoriasis is linked with an elevated incidence of cardiovascular risk, as based on a large body of epidemiological evidence,” Limin Zhang, of the department of dermatology at The First Hospital of China Medical University and the National Health Commission Key Laboratory of Immunodermatology, China, and colleagues wrote. “While there is evidence indicating a higher prevalence of cardiovascular disease in individuals with psoriasis, this relationship has been fraught with inconsistent findings.”
The researchers searched several databases (the Cochrane Library, Embase, Google Scholar, PubMed and Web of Science) for observational studies that evaluated possible links between risk factors for cardiovascular disease and psoriasis among East Asian and European populations, then performed meta-analyses on these studies. Zhang and colleagues used Mendelian randomization “to assess the causative impact of genetic predisposition for psoriasis on these CVD risk factors.” The study ultimately included nine articles about coronary artery disease, nine articles about myocardial infarction and six articles about heart failure across three different meta-analyses.
Psoriasis was associated with coronary artery disease in both the East Asian and European populations, Zhang and colleagues reported (relative risk = 1.51; 95% CI, 1.04–2.18; P = .028 for European and RR = 1.91; 95% CI, 1.62-2.25, P < .001 for East Asian patients). Similarly, psoriasis was reported to be significantly associated with myocardial infarction in both population groups (RR = 1.23; 95% CI, 1.04-1.46; P = .017 for European patients and RR = 2.17; 95% CI, 1.44-3.28; P < .001 for East Asian patients).
Furthermore, the researchers continued, psoriasis and coronary artery disease shared a “positive genetic relationship” in both the East Asian (inverse-variance weighted [IVW] OR = 1.18; 95% CI, 1.03-1.32; P = .031) and European populations (IVW OR = 1.03; 95% CI, 1.01-1.06; P = .005).
In the European population, Zhang and colleagues wrote that a Mendelian randomization approach suggested psoriasis shared a causal link with myocardial infarction (IVW OR = 1.05; 95% CI, 1.01-1.09, P = .026).
“In summary, from our study, we were able to establish a causal association of psoriasis with coronary artery disease and myocardial infarction. Such findings have important implications as they provide further support for the targeted treatment of psoriasis as a means of enhancing beneficial effects upon cardiovascular outcomes,” Zhang and colleagues wrote. “The possible mechanisms accounting for this causal relationship of psoriasis with coronary artery disease and myocardial infarction require further investigation.”Disclosures: No authors declared financial ties to drugmakers.
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