Risk of myocardial infarction and stroke in patients with keloids: A nationwide population-based cohort study

Background: Keloids represent a form of benign fibroproliferative disorder. Prior studies have linked various fibroproliferative conditions to an increased cardiovascular disease risk; however, the relationship between keloids and major adverse cardiovascular events, such as myocardial infarction (MI) and stroke, remains inadequately explored. A comprehensive nationwide population-based cohort approach was used to examine the cardiovascular disease risk in patients with keloids. Methods: The cohort comprised 554,501 patients with keloid and 1,109,002 matched controls. Primary measures included the incidence rates and incidence rate ratios of MI, ischemic stroke (IS), and hemorrhagic stroke (HS) compared to the matched controls. The study applied a stratified Cox regression hazard model to compute the relative hazards between patients with keloid and the controls. Results: Incidence rate ratios for cardiovascular diseases in patients with keloid, relative to controls, were 1.08 (95% confidence interval [CI], 1.06-1.10) for MI, 1.06 (CI, 1.04-1.08) for IS, and 1.05 (CI, 1.01-1.08) for HS. After adjusting for additional cardiovascular risk factors, a persistent elevated risk for MI and IS was evident in patients with keloid with adjusted hazard ratios (HRs) of 1.04 (CI 1.01-1.07) for MI and 1.03 (CI 1.00-1.07) for IS. Stratified analyses by age, sex, body mass index, and smoking status revealed consistent risk elevations in older individuals (>= 50 years), women, obese individuals, and nonsmokers. Conclusions: Keloids are associated with a significant increase in MI and IS risk, independent of the traditional cardiovascular risk factors. This association is particularly prominent in older adults, women, obese individuals, and nonsmokers. (c) 2025 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.