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Atopic eczema increases risk for CV outcomes
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Patients with severe atopic eczema that was predominately active had increased risk for CV outcomes, according to a study published in The BMJ.
Richard J. Silverwood, BSc, MSc, PhD, assistant professor in the faculty of epidemiology and population health at London School of Hygiene and Tropical Medicine, and colleagues analyzed data from 387,439 patients with atopic eczema from 1998 to March 2015. The onset of atopic eczema was defined as the latest diagnosis of the condition with two treatments that were prescriptions from primary care. Patients were categorized by the severity of atopic eczema: mild, moderate or severe.
Researchers also included data from 1,528,477 patients without atopic eczema that were matched by sex, age, calendar time at cohort entry and general practice. Patients remained in this cohort until they were diagnosed with the condition.
Patients were excluded from both groups if they had previous or current CVD, subarachnoid hemorrhagic strokes, epidural or subdural strokes and risk factors for subarachnoid hemorrhage.
Outcomes of interest included MI, HF, unstable angina, stroke, atrial fibrillation and CV death. Secondary outcomes were defined as coronary revascularization procedures.
Follow-up was conducted until death, the study end date, practice last collection date, transfer out of practice or when the patient developed an outcome of interest, for a median of 5.1 years.
The median age of the entire cohort was 43 years, and 66% were women.
Compared with patients without atopic eczema, those with the condition had increased risk for MI (adjusted HR = 1.06; 95% CI, 0.98-1.15), unstable angina (aHR = 1.25; 95% CI, 1.11-1.41), AF (aHR = 1.11; 95% CI, 1.04-1.18), HF (aHR = 1.19; 95% CI, 1.1-1.3) and stroke (aHR = 1.1; 95% CI, 1.02-1.19).
The effect was greatest in patients with the most active or most severe atopic eczema.
“Consideration should be given to developing prevention strategies to reduce the risk of cardiovascular disease among patients with severe or predominantly active atopic eczema, including awareness of and screening for conventional cardiovascular risk factors by those providing clinical care,” Silverwood and colleagues wrote. “Current biological treatments for atopic eczema have the potential to greatly change care for those with challenging eczema. The next objective will be to reduce the risk of cardiovascular outcomes.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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