Masson Walter, Rossi Emiliano, Galimberti María Laura, Krauss Juan, Navarro Estrada José, Galimberti Ricardo, Cagide Arturo
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Med Clin (Barc). 2017 Jun 7;148(11):483-488. doi: 10.1016/j.medcli.2016.12.011. Epub 2017 Jan 22.
The immune and inflammatory pathways involved in psoriasis could favor the development of atherosclerosis, consequently increasing mortality. The objectives of this study were: 1) to assess the mortality of a population with psoriasis compared to a control group, and 2) to assess the prevalence of cardiovascular risk factors.
A retrospective cohort was analyzed from a secondary database (electronic medical record). All patients with a diagnosis of psoriasis at 1-01-2010 were included in the study and compared to a control group of the same health system, selected randomly (1:1). Subjects with a history of cardiovascular disease were excluded from the study. A survival analysis was performed considering death from any cause as an event. Follow-up was extended until 30-06-2015.
We included 1,481 subjects with psoriasis and 1,500 controls. Prevalence of cardiovascular risk factors was higher in the group with psoriasis. The average follow-up time was 4.6±1.7 years. Mortality was higher in psoriasis patients compared to controls (15.1 vs. 9.6 events per 1,000 person-year, P<.005). Psoriasis was seen to be significantly associated with increased mortality rates compared to the control group in the univariate analysis (HR 1.58, 95% CI 1.16-2.15, P=.004) and after adjusting for cardiovascular risk factors (HR 1.48, 95% CI 1.08-2.3, P=.014).
In this population, patients with psoriasis showed a higher prevalence for the onset of cardiovascular risk factors as well as higher mortality rates during follow-up.
银屑病所涉及的免疫和炎症途径可能有利于动脉粥样硬化的发展，从而增加死亡率。本研究的目的是：1）评估银屑病患者群体与对照组相比的死亡率；2）评估心血管危险因素的患病率。
从二级数据库（电子病历）中分析回顾性队列。2010年1月1日诊断为银屑病的所有患者纳入本研究，并与同一医疗系统中随机选择的对照组（1:1）进行比较。有心血管疾病史的受试者被排除在研究之外。将任何原因导致的死亡作为事件进行生存分析。随访延长至2015年6月30日。
我们纳入了1481名银屑病患者和1500名对照。银屑病组心血管危险因素的患病率更高。平均随访时间为4.6±1.7年。银屑病患者的死亡率高于对照组（每1000人年15.1例事件对9.6例事件，P<0.005）。在单因素分析中，与对照组相比，银屑病与死亡率增加显著相关（风险比1.58，95%置信区间1.16 - 2.15，P = 0.004），在调整心血管危险因素后（风险比1.48，95%置信区间1.08 - 2.3，P = 0.014）也是如此。
在该人群中，银屑病患者心血管危险因素的起始患病率较高，且随访期间死亡率也较高。
