Risk of myocardial infarction in psoriasis patients: a retrospective cohort study

Background: Psoriasis may or may not be associated with a higher risk for myocardial infarction (MI). We sought to assess differences in MI incidence between control, mild psoriasis and severe psoriasis patients. Methods: We performed a retrospective cohort study of Kaiser Permanente Southern California members with psoriasis between 1 January 2004 and 30 June 2012, assessing the risk and incidence rates of MI. Results: There were 50 865 control patients matched to 10 173 patients with mild psoriasis and 19 205 control patients matched to 3841 patients with severe psoriasis. The MI incidence per 1000 person-years for mild psoriasis controls, mild psoriasis, severe psoriasis controls and severe psoriasis were 4.9, 6.7, 3.7 and 5.1, respectively. Upon multivariable analysis, mild psoriasis patients had a significantly higher risk of MI compared to matched control patients [hazard ratio (HR) = 1.31 [95% confidence interval (Cl): 1.14, 1.51]) and severe psoriasis patients had a significantly higher risk of MI compared to matched control patients [HR = 1.28 (95% Cl: 1.02, 1.60)]. Conclusion: Patients with psoriasis are at higher risk for MI compared to control patients.