The psoriasis area and severity index is an independent risk factor for cardiovascular events: A prospective register study.

Abstract

Patients treated with systemics for moderate-to-severe psoriasis have increased risk of cardiovascular disease (CVD). However, to the best of our knowledge, there are no data on the association between clinical disease activity and future cardiovascular events in this population. Such data could help identify patients at increased CVD risk and inform the potential for CVD prevention with effective psoriasis treatment. To estimate the association between the Psoriasis Area and Severity Index (PASI) and cardiovascular events defined as hospitalization for CVD and cardiovascular death. We linked prospectively collected data on PASI and CVD risk factors to population-based administrative data on hospitalizations and causes of death. We estimated the association between PASI and cardiovascular events using Cox proportional hazard models with PASI and Framingham 10-year cardiovascular risk as time-varying covariates. A total of 767 patients with 6264 PASI scores were included. After adjusting for 10-year cardiovascular risk and prior CVD, a one-point increase in PASI was associated with a hazard ratio of 1.04 (95% CI: 1.01-1.07) for cardiovascular events. The findings were robust in sensitivity analyses. PASI is an independent marker for future cardiovascular events in patients with moderate-to-severe psoriasis.