Incidence, Prevalence and Outcomes of Acute Myocardial Infarction in Hospitalized Patients with Psoriasis: Results from the Nationwide Inpatient Sample Database
Authors
Christopher G. Gibson1, Bhakti B. Chavan2, Ruby S. Gibson3, Francis Essien4, Melissa J. Newman1, Robert L. Zee1, Stephanie J. Ott5 and Irving L. Rosenberg5 1Department of Internal Medicine, Fairfield Medical Center, Lancaster, Ohio, USA; 2Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA; 3Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA; 4Department of Internal Medicine, Keesler Air Force Base, Biloxi, MS, USA; 5Department of Rheumatology at the Fairfield Medical Center, Lancaster, OH, USA
Background: Psoriasis (PsO) is a chronic multisystem inflammatory condition that has been linked with increased cardiovascular mortality most notably in patients with a severe disease burden. This inflammatory process is driven by an increase in several markers including: C-reactive protein (CRP), cytokines, and acute phase reactants which promote the development and progression of atherosclerosis. Endothelial dysfunction is central to the disease pathophysiology and accelerated atherosclerosis results in a higher risk of Acute Myocardial Infarction (AMI), stroke and peripheral vascular disease (PVD). There is a paucity of literature describing the inpatient burden, prevalence, and socioeconomic status of hospitalized psoriasis patients diagnosed with AMI. The purpose of this article is to subsidize the literature by evaluating a nationwide database to compare the incidence, prevalence, and inpatient burden of AMI in patients with and without psoriasis. Methods and Results: A total of 31,713 patients were diagnosed with PsO in a sample size of 7,135,090. Table 2 shows the distributions of sociodemographic characteristics and selected comorbid medical disorders for patients with psoriasis and patients in the comparison cohort. Patients with psoriasis demonstrated a statistically significant increased risk of AMI in adjusted and unadjusted analyses. Conclusion: The correlation between atherosclerosis and aggressive therapy suggests that more vigorous therapy might decrease the likelihood and burden of atherosclerosis in patients with PsO and thus a lower incidence of AMI.
