Prevalence of myocardial infarction in patients with psoriasis in central China

Objective To explore whether the prevalence of myocardial infarction (MI) was higher in psoriatics than in patients without psoriasis, and whether major cardiovascular risk factors were associated with psoriasis in central China. Methods Data were collected at Medical Records Section of Affiliated Union Hospital, Tongji Hospital, Wuhan Iron and Steel Company General Hospital and No. 1 Hospital of Wuhan between 1999 and 2007. Patients with psoriasis were classified as severe if they ever received a systemic therapy. And patients were classified as having risk factors if they received codes for diabetes, hypertension, hyperlipidemia, or smoking. Controls without psoriasis were randomly selected from the Physical Examination Centre in the Affiliated Union Hospital. Analysis was performed by using conditional logistic regression, and adjustments were made for age and sex. Results There were 45 MIs (2.96%) within the control population and 97 (6.00%) and 118 (8.01%) MIs within the mild and severe psoriasis groups, respectively. Respective odds ratio (OR) and 95% confidence interval (95% CI) of cardiovascular risk factors in those with mild psoriasis than controls were as follows: obesity (OR, 1.41; 95% CI, 1.08-1.85), diabetes (OR, 1.45; 95% CI, 1.11-1.91), hypertension (OR, 1.39; 95% CI, 1.04-1.85), hyperlipidemia (OR, 1.37; 95% CI, 1.06-1.78) and smoking (OR, 1.35; 95% CI, 1.01-1.80). Patients with severe psoriasis had higher adjusted odds of obesity (OR, 1.51; 95% CI, 1.15-1.98), diabetes (OR, 1.69; 95% CI, 1.32-2.17), hypertension (OR, 1.41; 95% CI, 1.06-1.88), hyperlipidemia (OR, 1.43; 95% CI, 1.11-1.84), and smoking (OR, 1.57; 95% CI, 1.20-2.05) than patients with mild psoriasis and controls. After adjusting for systemic therapies and cardiovascular risk factors (obesity, diabetes, hypertension, hyperlipidemia and smoking) in addition to age and sex, for patients with mild or severe psoriasis, the OR of having an MI was 1.72 (95% CI, 1.29-2.30) and 2.01 (95% CI, 1.45-2.79), respectively. Conclusions The prevalence of MI is higher in mild andsevere psoriasis than in patients without psoriasis in central China. In addition, MI and major cardiovascular risk factors (e.g. diabetes, hypertension, hyperlipidemia and smoking) are associated with psoriasis in central China.