Patients with psoriasis have an increased risk of abdominal aortic aneurysm (AAA) that is greater with more severe disease, researchers report.
“It is now well established that patients living with psoriasis have an increased risk of various cardiovascular diseases,” Dr. Usman Khalid, from Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark, told Reuters Health by email. “In this perspective, it is not entirely surprising to see a heightened risk of AAA in patients with psoriasis. But it is interesting to see that the risk increases with respect to disease severity.”
Some studies have reported an increased risk of AAA in other autoimmune disorders, and recent evidence revealed similarities between central inflammatory pathways involved in AAA and those occurring in psoriasis.
Dr. Khalid’s team used Danish national registries to investigate the risk of AAA in 70,989 patients with psoriasis compared with more than 5.4 million individuals in the general population. The incidences of AAA per 10,000 person-years were 7.30 in patients with mild psoriasis and 9.87 in patients with severe psoriasis, compared with 3.72 in the general population, according to the April 14 Arteriosclerosis, Thrombosis, and Vascular Biology online report.
In fully adjusted models, the risk of AAA was 20% higher in patients with mild psoriasis and 67% higher in patients with severe psoriasis, compared with the general population. The risk of ruptured AAA was also increased by 60% in mild psoriasis and by 94% in severe psoriasis. By comparison, there was no significant association between osteoarthritis and the risk of AAA.
“The clinical consequences of our findings are unclear at the present and need further study,” Dr. Khalid said. “Nevertheless, our results confirm the high risk of cardiovascular comorbidities in psoriasis and therefore it is important for this patient group to be aware of this risk and get regularly assessed for the relevant risk factors.”
“Also, clinicians should be more vigilant in monitoring cardiovascular-related elements in these patients to reduce their risk,” Dr. Khalid said. “It is too early to suggest any special surveillance for AAA in psoriatic individuals. Further investigation is required to reproduce our results in other populations with different patient characteristics.”
Dr. Guo-Ping Shi from Brigham and Women’s Hospital and Harvard Medical School, Boston, who recently showed an increased risk of AAA and rupture in asthma patients, told Reuters Health by email, “Patients, especially men, with other autoimmune diseases may also have higher risk of developing AAA and should be examined at least periodically.”