Mortalidad en pacientes con psoriasis. Análisis de una cohorte retrospectiva

Masson, Walter; Rossi, Emiliano; Galimberti, María Laura; Krauss, Juan; Estrada, José Navarro; Galimberti, Ricardo; Cagide, Arturo

doi:10.1016/j.medcli.2016.12.011

Cited by 14 publications

(4 citation statements)

References 25 publications

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“…Additionally, a retrospective cohort of patients with psoriasis showed higher mortality rates during follow-up compared with the control group [53]. In the same way, another study showed that patients with severe psoriasis have an increased risk of cardiovascular mortality that is independent of traditional cardiovascular risk factors [54].…”

Section: Association Between Psoriasis and Cardiovascular Eventsmentioning

confidence: 86%

Psoriasis and Cardiovascular Risk: A Comprehensive Review

Masson

Lobo²,

Molinero³

2020

Adv Ther

Self Cite

129

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Psoriasis is a systemic inflammatory disorder that involves complex pathogenic interactions between the innate and adaptive immune systems. Individuals with psoriasis have an increased risk of developing other chronic health diseases such cardiovascular disorders. The high incidence of cardiovascular events in the population with psoriasis could be explained by several mechanisms. The high prevalence of traditional cardiovascular risk factors and metabolic abnormalities contributes to the high cardiovascular burden in patients with psoriasis. Likewise, the presence of systemic inflammation in combination with metabolic abnormalities may act in a synergistic manner to increase cardiovascular risk in these patients. This review focused on epidemiologic and clinical evidence linking psoriasis to cardiovascular risk factors and cardiovascular disease. We described the possible pathophysiological mechanisms that justify this association and analyzed the best way to stratify the cardiovascular risk in patients with psoriasis. We also described the usefulness of the therapies frequently used in cardiovascular prevention and analyzed the impact of the specific psoriasis medication on cardiovascular risk factors or major atherosclerotic events. Knowledge of the application of different cardiovascular prevention strategies could mean an advantage in performing the difficult task of estimating cardiovascular risk and treating cardiovascular risk factors in this particular group of patients.

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Section: Association Between Psoriasis and Cardiovascular Eventsmentioning

confidence: 86%

Psoriasis and Cardiovascular Risk: A Comprehensive Review

Masson

Lobo²,

Molinero³

2020

Adv Ther

Self Cite

129

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that mortality rates are increased in psoriasis patients compared to healthy controls [ 16 , 17 , 18 ], and the life expectancy of patients with moderate to severe psoriasis is decreased by approximately 5 years, mainly due to cardiovascular comorbidities [ 19 ]. Furthermore, the presence of cardiovascular comorbidities in patients with psoriasis has been found to be associated with greatly increased economic and healthcare burden [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Lan

2017

IJMS

152

121

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Psoriasis is a common and chronic inflammatory disease of the skin. It may impair the physical and psychosocial function of patients and lead to decreased quality of life. Traditionally, psoriasis has been regarded as a disease affecting only the skin and joints. More recently, studies have shown that psoriasis is a systemic inflammatory disorder which can be associated with various comorbidities. In particular, psoriasis is associated with an increased risk of developing severe vascular events such as myocardial infarction and stroke. In addition, the prevalence rates of cardiovascular risk factors are increased, including hypertension, diabetes mellitus, dyslipidemia, obesity, and metabolic syndrome. Consequently, mortality rates have been found to be increased and life expectancy decreased in patients with psoriasis, as compared to the general population. Various studies have also shown that systemic treatments for psoriasis, including methotrexate and tumor necrosis factor-α inhibitors, may significantly decrease cardiovascular risk. Mechanistically, the presence of common inflammatory pathways, secretion of adipokines, insulin resistance, angiogenesis, oxidative stress, microparticles, and hypercoagulability may explain the association between psoriasis and cardiometabolic disorders. In this article, we review the evidence regarding the association between psoriasis and cardiovascular comorbidities, focusing on severe vascular events, cardiovascular risk factors and implications for treatment.

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“…Chronic inflammatory disorders, including psoriasis, are characterized by enhanced atherosclerosis and consequently higher cardiovascular morbidity and mortality rates compared with the general population 1, 2, 3, 4…”

Section: Introductionmentioning

confidence: 99%

Should all patients with psoriasis receive statins? Analysis according to different strategies

Masson

Lobo²,

Molinero³

et al. 2019

Anais Brasileiros de Dermatologia

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BackgroundDifferent strategies have been proposed for the cardiovascular risk management of patients with psoriasis.ObjectiveTo estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy.MethodsA retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed.ResultsA total of 892 patients (mean age 59.9 ± 16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1–27.0%) and 1.9% (IQR 0.4–5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies: 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively.Study limitationsThis was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis.ConclusionThis population with psoriasis was mostly classified at moderate–high risk and the statin therapy indication was similar when applying the two strategies evaluated.

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Mortalidad en pacientes con psoriasis. Análisis de una cohorte retrospectiva

Cited by 14 publications

References 25 publications

Psoriasis and Cardiovascular Risk: A Comprehensive Review

Psoriasis and Cardiovascular Risk: A Comprehensive Review

Psoriasis and Cardiovascular Comorbidities: Focusing on Severe Vascular Events, Cardiovascular Risk Factors and Implications for Treatment

Should all patients with psoriasis receive statins? Analysis according to different strategies

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