Risk of Cardiovascular Morbidity in Patients With Psoriatic Arthritis: A Meta-Analysis of Observational Studies

被引:160
作者
Polachek, Ari [1 ]
Touma, Zahi [2 ]
Anderson, Melanie [3 ]
Eder, Lihi [4 ]
机构
[1] Univ Toronto, Toronto Western Hosp, Toronto, ON, Canada
[2] Univ Toronto, Toronto Western Hosp, Ctr Prognosis Studies Rheumat Dis, Toronto, ON, Canada
[3] Univ Hlth Network, Toronto, ON, Canada
[4] Univ Toronto, Womens Coll Hosp, Womens Coll Res Inst, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
RHEUMATOID-ARTHRITIS; SUBCLINICAL ATHEROSCLEROSIS; METABOLIC SYNDROME; HIGH PREVALENCE; DISEASE; EVENTS; INFLAMMATION; BIAS;
D O I
10.1002/acr.22926
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
ObjectiveTo assess the magnitude of risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis (PsA) compared with the general population through a systematic review and meta-analysis of observational studies. MethodsWe searched the Medline, Embase, and Cochrane databases, as well as abstracts archives from rheumatology conferences. Observational studies that included a PsA diagnosis, cardiovascular or cerebrovascular outcomes, and a comparison group of individuals without psoriasis and rheumatic diseases and were case-control, cross-sectional, or cohort studies, were assessed by 2 researchers. We calculated weighted pooled summary estimates of the maximally adjusted effect size estimates for cardiovascular and cerebrovascular diseases using the random-effects model, and tested for heterogeneity using the I-2 statistic. ResultsEleven studies, comprising 32,973 patients with PsA, met the inclusion criteria. There was a 43% increased risk of cardiovascular diseases in patients with PsA compared with the general population (pooled odds ratio [OR] 1.43 [95% confidence interval (95% CI) 1.24-1.66]). The risk of incident cardiovascular events was increased by 55% (pooled OR 1.22-1.96). Morbidity risks for myocardial infarction, cerebrovascular diseases, and heart failure were increased by 68%, 22%, and 31%, respectively (pooled OR 1.68 [95% CI 1.31-2.15], pooled OR 1.22 [95% CI 1.05-1.41], and pooled OR 1.31 [95% CI 1.11-1.55], respectively). We identified significant heterogeneity in all main analyses (P<0.001). ConclusionCardiovascular and cerebrovascular morbidity are increased by 43% and 22%, respectively, in patients with PsA compared with the general population.
引用
收藏
页码:67 / 74
页数:8
相关论文
共 41 条
[1]   Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study [J].
Ahlehoff, O. ;
Gislason, G. H. ;
Charlot, M. ;
Jorgensen, C. H. ;
Lindhardsen, J. ;
Olesen, J. B. ;
Abildstrom, S. Z. ;
Skov, L. ;
Torp-Pedersen, C. ;
Hansen, P. R. .
JOURNAL OF INTERNAL MEDICINE, 2011, 270 (02) :147-157
[2]   Psoriasis and Major Adverse Cardiovascular Events: A Systematic Review and Meta-Analysis of Observational Studies [J].
Armstrong, Ehrin J. ;
Harskamp, Caitlin T. ;
Armstrong, April W. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2013, 2 (02) :e000062
[3]  
Bengtsson K, 2015, ARTHRITIS RHEUMATOL, V67
[4]   METAANALYSIS IN CLINICAL-TRIALS [J].
DERSIMONIAN, R ;
LAIRD, N .
CONTROLLED CLINICAL TRIALS, 1986, 7 (03) :177-188
[5]   Cardiovascular risk markers in patients with psoriatic arthritis: A meta-analysis of literature studies [J].
Di Minno, Matteo Nicola Dario ;
Ambrosino, Pasquale ;
Lupoli, Roberta ;
Di Minno, Alessandro ;
Tasso, Marco ;
Peluso, Rosario ;
Tremoli, Elena .
ANNALS OF MEDICINE, 2015, 47 (04) :346-353
[6]   Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study [J].
Dubreuil, Maureen ;
Rho, Young Hee ;
Man, Ada ;
Zhu, Yanyan ;
Zhang, Yuqing ;
Love, Thorvardur Jon ;
Ogdie, Alexis ;
Gelfand, Joel M. ;
Choi, Hyon K. .
RHEUMATOLOGY, 2014, 53 (02) :346-352
[7]  
Eder L, 2008, J RHEUMATOL, V35, P877
[8]   Incidence and predictors for cardiovascular events in patients with psoriatic arthritis [J].
Eder, Lihi ;
Wu, Ying ;
Chandran, Vinod ;
Cook, Richard ;
Gladman, Dafna D. .
ANNALS OF THE RHEUMATIC DISEASES, 2016, 75 (09) :1680-1686
[9]   The Framingham Risk Score underestimates the extent of subclinical atherosclerosis in patients with psoriatic disease [J].
Eder, Lihi ;
Chandran, Vinod ;
Gladman, Dafna D. .
ANNALS OF THE RHEUMATIC DISEASES, 2014, 73 (11) :1990-1996
[10]   Serum adipokines in patients with psoriatic arthritis and psoriasis alone and their correlation with disease activity [J].
Eder, Lihi ;
Jayakar, Jai ;
Pollock, Remy ;
Pellett, Fawnda ;
Thavaneswaran, Arane ;
Chandran, Vinod ;
Rosen, Cheryl F. ;
Gladman, Dafna D. .
ANNALS OF THE RHEUMATIC DISEASES, 2013, 72 (12) :1956-1961