Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China.
Br J Dermatol. 2012 Dec;167(6):1345-50. doi: 10.1111/bjd.12002. Epub 2012 Nov 20.
Psoriasis is a common, chronic, relapsing, inflammatory skin disorder. Observational studies suggest an association between psoriasis and the incidence of stroke or myocardial infarction (MI). However, whether psoriasis is an independent risk factor for these two vascular events remains controversial.
To evaluate the association of psoriasis with stroke and MI by conducting a meta-analysis of cohort studies.
Cohort studies were searched in MEDLINE (Pubmed), EMBASE and Cochrane Library from their inception to March 2012. Stroke and MI were considered as a composite endpoint. Two authors independently extracted information on the characteristics of the study participants, follow-up range and control for potential confounding factors. A random-effects model was used to calculate the overall combined risk estimates.
Seven cohort studies were included in the meta-analysis. On the basis of cohort characteristics, five of them were considered good quality and two were fair. The overall combined relative risk for psoriasis and composite vascular endpoint was 1·2 (95% confidence interval 1·1-1·31). Subgroup analysis maintained this significance with respect to stroke and MI individually. Sensitivity analysis and 'trim and fill' method yielded similar results. No evidence of publication bias was observed.
This meta-analysis of cohort studies suggests that psoriasis significantly increases the risk of stroke and MI. The increase is probably independent of conventional cardiovascular risk factors.
银屑病是一种常见的、慢性的、复发性炎症性皮肤病。观察性研究表明，银屑病与中风或心肌梗死（MI）的发病率之间存在关联。然而，银屑病是否是这两种血管事件的独立危险因素仍存在争议。
通过对队列研究进行荟萃分析，评估银屑病与中风和 MI 的相关性。
从 MEDLINE（Pubmed）、EMBASE 和 Cochrane Library 中检索队列研究，检索时间从建库至 2012 年 3 月。将中风和 MI 视为复合终点。两位作者独立提取研究参与者特征、随访范围和潜在混杂因素控制的信息。采用随机效应模型计算总体综合风险估计值。
荟萃分析纳入了 7 项队列研究。根据队列特征，其中 5 项被认为是高质量的，2 项是中等质量的。银屑病和复合血管终点的总体综合相对风险为 1.2（95%置信区间 1.1-1.31）。亚组分析对中风和 MI 分别进行分析时仍具有统计学意义。敏感性分析和“修剪和填充”方法得出了相似的结果。未观察到发表偏倚的证据。
这项对队列研究的荟萃分析表明，银屑病显著增加了中风和 MI 的风险。这种增加可能独立于传统的心血管危险因素。
