Jain Hritvik, Odat Ramez M, Goyal Aman, Jain Jyoti, Dey Debankur, Ahmed Mushood, Wasir Amanpreet Singh, Passey Siddhant, Gole Shrey
Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.
Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Curr Probl Cardiol. 2024 Jun;49(6):102538. doi: 10.1016/j.cpcardiol.2024.102538. Epub 2024 Mar 21.
Psoriasis is a prevalent inflammatory skin condition characterized by erythematous plaques with scaling. Recent research has demonstrated an increased risk of cardiovascular diseases in patients with psoriasis; however, current evidence on atrial fibrillation (AF) risk in psoriasis is limited.
A systematic literature search was performed on major bibliographic databases to retrieve studies that evaluated AF risk in patients with psoriasis. The DerSimonian and Laird random effects model was used to pool the hazard ratios (HR) with 95 % confidence intervals (CI). Subgroup analysis was conducted by dividing the patients into mild and severe psoriasis groups. Publication bias was assessed by visual inspection and Egger's regression test. Statistical significance was set at p < 0.05.
Seven studies were included, with 10,974,668 participants (1,94,230 in the psoriasis group and 10,780,439 in the control group). Patients with psoriasis had a significantly higher risk of AF [Pooled HR: 1.28; 95 % CI: 1.20, 1.36; p < 0.00001]. In subgroup analysis, patients with severe psoriasis [HR: 1.32; 95 % CI: 1.23, 1.42; p < 0.00001] demonstrated a slightly higher risk of AF, although statistically insignificant (p = 0.17), than the mild psoriasis group [HR: 1.21; 95 % CI: 1.10, 1.33; p < 0.0001]. Egger's regression test showed no statistically significant publication bias (p = 0.24).
Our analysis demonstrated that patients with psoriasis are at a significantly higher risk of AF and hence should be closely monitored for AF. Further large-scale and multicenter randomized trials are warranted to validate the robustness of our findings.
银屑病是一种常见的炎症性皮肤病，其特征为伴有鳞屑的红斑斑块。近期研究表明，银屑病患者患心血管疾病的风险增加；然而，目前关于银屑病患者发生心房颤动（AF）风险的证据有限。
在主要的文献数据库中进行系统的文献检索，以获取评估银屑病患者AF风险的研究。采用DerSimonian和Laird随机效应模型汇总风险比（HR）及95%置信区间（CI）。通过将患者分为轻度和重度银屑病组进行亚组分析。通过直观检查和Egger回归检验评估发表偏倚。设定统计学显著性为p<0.05。
纳入7项研究，共10,974,668名参与者（银屑病组194,230名，对照组10,780,439名）。银屑病患者发生AF的风险显著更高[汇总HR：1.28；95%CI：1.20,1.36；p<0.00001]。亚组分析中，重度银屑病患者[HR：1.32；95%CI：1.23,1.42；p<0.00001]发生AF的风险虽比轻度银屑病组略高（p = 0.17），但差异无统计学意义，轻度银屑病组[HR：1.21；95%CI：1.10,1.33；p<0.0001]。Egger回归检验显示无统计学显著的发表偏倚（p = 0.24）。
我们的分析表明，银屑病患者发生AF的风险显著更高，因此应密切监测AF。有必要进一步开展大规模多中心随机试验，以验证我们研究结果的稳健性。
