32607 Risk of cardiovascular events and all cause mortality in patients with atopic dermatitis: A population-based cohort study

Abstract

Atopic dermatitis (AD) is a systemic inflammatory disorder that may increase risk for cardiovascular (CV) events, but data are limited, particularly in children. We performed a population-based cohort study to quantify the risk of CV events and all-cause mortality in AD patients using a UK-based electronic medical records database from 1994 to 2015. 625,083 adults (≥18 y) and 409,431 children (<18 y) with AD were matched on age, practice, index date to 2,678,888 adult and 1,809,029 pediatric unaffected controls, respectively. In adults, we observed an association between AD and stroke (HR 1.04 [1.02-1.06]), particularly among those with severe AD (HR 1.21 [1.13-1.30]). Severe AD was associated with an increased risk of MI (HR 1.27 [1.15-1.39]) while no difference was detected for mild or moderate AD. Relative to non-AD controls, the risk of death was elevated among patients with mild AD (HR 1.13 [1.12-1.14]), but lower among those with moderate (HR 0.90 [0.89-0.91]) and at unity in severe AD (HR 0.99 [0.94-1.03]). In children, severe AD was associated with greater risk of stroke (HR 2.43 [1.13-5.22]). There was no association between pediatric AD and MI (HR 0.75 [0.28-1.99]). Compared with controls, the risk of death was lower among children with AD, particularly among those with mild or moderate disease (HRs 0.75 [0.66-0.85] and 0.48 [0.33-0.70], respectively). In conclusion, severe AD appeared to be associated with increased risk of several major CV events but not mortality, supporting the need for additional investigation into this relationship, as this is critical in understanding natural history of disease.