Abstract
Background
Previous research in non-dialysis patients suggests that the inflammatory skin disease
psoriasis is associated with an increased risk of severe vascular events like myocardial
infarction (MI). Thus, we determined whether psoriasis represents a significant risk
factor for MI in end-stage renal disease (ESRD) patients.
Methods
We queried the United States Renal Data System for ESRD patients starting dialysis
between 2004 and 2015. ICD-9 and ICD-10 codes were used to identify those with at
least two diagnoses of psoriasis, a diagnosis of MI, and other clinical risk factors.
Logistic regression was used to examine the association of psoriasis and various risk
factors with MI.
Results
Of a cohort of 1,062,693, we identified 6823 (0.6%) subjects with psoriasis and 181,960
(17.1%) with MI. Of the 6823 patients with psoriasis, 1671 (24%) developed an MI.
Psoriasis was associated with an increased risk of MI in an unadjusted model [odds
ratio (OR) = 1.34; confidence interval (CI) = 1.26–1.42]. However, after controlling
for demographics, dialysis modality, access type, and various conditions related to
the Charlson Comorbidity Index, psoriasis was not associated with MI (OR = 0.95, CI = 0.89–1.01).
Confounders of the association of psoriasis with MI included congestive heart failure
(OR = 5.26, CI = 5.17–5.36), pulmonary disease (OR = 1.25, CI = 1.23–1.26), and diabetes
with complications (OR = 1.82, CI = 1.79–1.85).
Conclusions
Contrary to prior research in the general population, in the ESRD population psoriasis
was not associated with an increased risk of MI after controlling for various demographic
and clinical parameters. These data emphasize the importance of an integrated approach
since comorbidities may influence the choice of therapy for psoriasis and outcomes.
Key Indexing Terms
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Article info
Publication history
Published online: August 28, 2022
Accepted:
August 9,
2022
Received:
January 26,
2022
Identification
Copyright
Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
