Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study
Open accessAbstract
Objectives We aimed to quantify the risk of major adverse cardiovascular events (MACE) among patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA) and psoriasis without known PsA compared with the general population after adjusting for traditional cardiovascular risk factors.Methods A population-based longitudinal cohort study from 1994 to 2010 was performed in The Health Improvement Network (THIN), a primary care medical record database in the UK. Patients aged 18-89 years of age with PsA, RA or psoriasis were included. Up to 10 unexposed controls matched on practice and index date were selected for each patient with PsA. Outcomes included cardiovascular death, myocardial infarction, cerebrovascular accidents and the composite outcome (MACE). Cox proportional hazards models were used to calculate the HRs for each outcome adjusted for traditional risk factors. A priori, we hypothesised an interaction between disease status and disease-modifying antirheumatic drug (DMARD) use.Results Patients with PsA (N=8706), RA (N=41 752), psoriasis (N=138 424) and unexposed controls (N=81 573) were identified. After adjustment for traditional risk factors, the risk of MACE was higher in patients with PsA not prescribed a DMARD (HR 1.24, 95% CI 1.03 to 1.49), patients with RA (No DMARD: HR 1.39, 95% CI 1.28 to 1.50, DMARD: HR 1.58, 95% CI 1.46 to 1.70), patients with psoriasis not prescribed a DMARD (HR 1.08, 95% CI 1.02 to 1.15) and patients with severe psoriasis (DMARD users: HR 1.42, 95% CI 1.17 to 1.73).Conclusions Cardiovascular risk should be addressed with all patients affected by psoriasis, PsA or RA.
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Autoimmune diseases including rheumatoid arthritis, SLE, psoriasis, and anti-phospholipid syndrome are characterized by enhanced atherosclerosis and higher CV morbidity and mortality compared with the general population.
“Autoimmune diseases, including rheumatoid arthritis, SLE, psoriasis and anti-phospholipid syndrome, are characterized by enhanced atherosclerosis and consequently higher CV morbidity and mortality rates compared with the general population. 383-385”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [384]
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- Authors
- Ogdie, A., Yu, Y., Haynes, K., Love, T. J., Maliha, S., Jiang, Y., Troxel, A. B., Hennessy, S., Kimmel, S. E., Margolis, D. J., Choi, H., Mehta, N. N., & Gelfand, J. M.
- Affiliations
- University of Pennsylvania (US)
- Brigham and Women's Hospital (US)
- New York University (US)
- Boston University (US)
- National Heart, Lung, and Blood Institute (US)
- Corresponding author
- Ogdie, Alexis
- ORCID
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 74
- Issue
- 2
- Pages
- 326-332
- ISSN
- 0003-4967 (ISSN-L)
- PMC
- PMC4341911
- OpenAlex
- W2133701923
- Cited by
- 490
- References
- 50
- Citations by year
- 2026: 22 · 2025: 26 · 2024: 48 · 2023: 38 · 2022: 39 · 2021: 53 · 2020: 43 · 2019: 40 · 2018: 43 · 2017: 56 · 2016: 42 · 2015: 32 · 2014: 6 · 2013: 1
- FWCI
- 37.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Funders
- Doris Duke Charitable Foundation
- American College of Rheumatology Research and Education Foundation
- University of Pennsylvania
- National Institutes of Health (UL1TR000003)
- National Institute on Aging (R01AG025152)
- National Heart, Lung, and Blood Institute (K23HL097151, R01HL089744)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (L30 AR060070, K23AR063764, K24AR064310)
- National Center for Research Resources
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Rheumatology › Spondyloarthritis Studies and Treatments
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- psoriatic arthritis, rheumatoid arthritis, psoriasis, major adverse cardiovascular events, cardiovascular risk, disease-modifying antirheumatic drugs, myocardial infarction, stroke, cardiovascular mortality, traditional cardiovascular risk factors
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid, Cardiovascular Diseases, Female, Humans, Longitudinal Studies, Male, Middle Aged, Risk Factors, Cohort Studies, Arthritis, Psoriatic, Proportional Hazards Models, Antirheumatic Agents, Young Adult
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