Venous thromboembolism, peripheral vascular disease risks increase with psoriatic disease
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Patients with psoriatic disease had a higher incidence of venous thromboembolism and peripheral vascular disease, according to a study.
“Patients with psoriasis have been found to be up to 50% more likely to develop cardiovascular comorbidities,” Tai-Li Chen, MD, of the Department of Medical Education, Medical Administration Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, in Hualien, Taiwan, and colleagues wrote. “Activated immune responses in psoriasis may contribute to vascular inflammation and subsequent atherosclerosis.”
Researchers conducted a systematic review and meta-analysis of 13 cohort studies to evaluate the incidence of venous thromboembolism (VTE) and peripheral vascular disease (PVD) in patients with psoriasis.
The association between VTE and psoriasis was studied in nine of the studies, which included more than 12 million subjects, and found an increased risk in these patients compared to those without psoriasis (pooled HR = 1.26; 95% CI, 1.08-1.48; I² = 93%).
This association remained significant when stratified for those with psoriatic arthritis (pooled HR = 1.24; 95% CI, 1.01-1.53), while it was not significant in those with psoriasis alone (pooled HR, 0.97; 95% CI, 0.78-1.21).
In addition, the risk remained significant in women (pooled HR = 1.89; 95% CI, 1.36-2.61), but was not significantly increased in men. Subgroup analyses also identified increased risk in those from Asia (pooled HR = 2.02; 95% CI, 1.42-2.88) and Europe (pooled HR = 1.28; 95% CI, 1.06-1.53).
The risk of PVD in four of the studies including 383,201 patients was also higher for those with psoriasis (pooled HR = 1.27; 95% CI, 1.16-1.4; I² = 0%).
“The results of this study suggest that psoriasis is associated with increased risk for VTE and PVD, especially in patients with psoriatic arthritis, women and patients located in Asia and Europe,” the authors wrote. “Physicians and patients with psoriasis should be aware of the risk of VTE and PVD ... Risk factors, such as obesity, physical inactivity, smoking and varicose veins should be identified and treated in patients with psoriasis, and medications like hormone-related therapies should be prescribed cautiously.”