Cardiovascular risk in patients with alopecia areata (AA): A propensity-matched retrospective analysis

Background: The cardiovascular risk of patients with alopecia areata (AA) is not well characterized, with limited studies evaluating the risk of acute myocardial infarction (AMI) and ischemic stroke. Objective: We sought to determine the risk for patients with AA to develop subsequent stroke and AMI. Methods: We conducted propensity-matched retrospective analysis between January 1, 2000, and January 1, 2010, from Brigham and Women's Hospital and Massachusetts General Hospital in Boston, MA. A comprehensive research patient data repository search was done for International Classification of Diseases, Ninth Revision code 704.01 and cases were verified using a natural language processing program. Propensity score matching was used to identify controls for AA cases based on age, race, gender, smoking status, and history of hypertension, diabetes, and hyperlipidemia. Results: We identified 1377 cases of AA matched with 4131 controls. Patients with AA had decreased odds for developing stroke (odds ratio 0.39, 95% CI 0.18-0.87) and a trend toward decreased risk of AMI (odds ratio 0.91, 95% CI 0.59-1.39). Limitations: This was a retrospective study using a clinical database. Conclusion: Patients with AA had decreased risk for stroke and AMI, although not statistically significant. Further studies are needed to confirm these findings in other AA cohorts and to elucidate a potential mechanism.