Limits...
Cardiovascular Disease Outcomes Associated with Three Major Inflammatory Dermatologic Diseases: A Propensity-Matched Case Control Study

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Inflammation is an established component of cardiovascular disease (CVD) and an underlying factor of several dermatologic conditions including rosacea, atopic dermatitis, and psoriasis. Identifying potential associations between these dermatologic and cardiovascular diseases can better inform holistic healthcare approaches. The objective of this study was to determine whether rosacea, psoriasis or atopic dermatitis are independent risk factors for CVD 1 year following diagnosis.

Methods: Using a large commercial claims database of 21,801,147 lives, we employed a propensity-matched logistic regression to evaluate the association between diagnoses of rosacea, psoriasis, or atopic dermatitis and a 1-year risk of being diagnosed with cardiovascular disease. Control patients were matched based on health-care utilization, age and overall health status as defined by a modified Deyo–Charlson comorbidity index.

Results: The analysis included 2105 rosacea, 622 atopic dermatitis, 1536 psoriasis, and 4263 control patients. Compared to propensity-matched controls, the adjusted odds of cardiovascular disease were not higher in patients with rosacea (odds ratio: 0.894, p = 0.2713), atopic dermatitis (OR 1.032, p = 0.8489), or psoriasis (OR 1.087, p = 0.4210). In univariate analysis, the unadjusted odds of cardiovascular disease was higher in patients with psoriasis (OR 1.223, p = 0.0347).

Conclusions: Limitations of this study include the short follow-up period and inclusion of only commercially insured patients limit the generalizability of these findings. In this large study of patients with rosacea, atopic dermatitis, and psoriasis, we did not detect an increased 1-year risk of cardiovascular disease after adjusting for confounders.

Electronic supplementary material: The online version of this article (doi:10.1007/s13555-016-0144-3) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus

Flow diagram to identify exposure groups
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC5120633&req=5

Fig1: Flow diagram to identify exposure groups

Mentions: The sample sizes for the disease and control groups were arrived at separately. For the dermatologic disease group, we began with people having either outpatient or inpatient visits with ages inclusive between 30 and 64 years (n = 21,801,147). After excluding patients that lacked diagnosis criteria, sufficient wash-out period, at least 1 year of follow-up, and at least one outpatient record, there were 4263 remaining patients (Fig. 1). For the control group, we began with a simple random sample of 20,000 people from the 2006 database. After excluding those of age less than 30 years or greater than 64 years, with less than 12 months of continuous enrollment, or with a diagnosis of the dermatologic diseases investigated, there were 14,162 patients. Following the propensity score matching with the combined dermatologic disease group, the control sample size was 4263 patients. Our sample consisted of n = 8526 people, matched 1:1 between the dermatologic diseases and control groups.Fig. 1


Cardiovascular Disease Outcomes Associated with Three Major Inflammatory Dermatologic Diseases: A Propensity-Matched Case Control Study
Flow diagram to identify exposure groups
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120633&req=5

Fig1: Flow diagram to identify exposure groups
Mentions: The sample sizes for the disease and control groups were arrived at separately. For the dermatologic disease group, we began with people having either outpatient or inpatient visits with ages inclusive between 30 and 64 years (n = 21,801,147). After excluding patients that lacked diagnosis criteria, sufficient wash-out period, at least 1 year of follow-up, and at least one outpatient record, there were 4263 remaining patients (Fig. 1). For the control group, we began with a simple random sample of 20,000 people from the 2006 database. After excluding those of age less than 30 years or greater than 64 years, with less than 12 months of continuous enrollment, or with a diagnosis of the dermatologic diseases investigated, there were 14,162 patients. Following the propensity score matching with the combined dermatologic disease group, the control sample size was 4263 patients. Our sample consisted of n = 8526 people, matched 1:1 between the dermatologic diseases and control groups.Fig. 1

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Inflammation is an established component of cardiovascular disease (CVD) and an underlying factor of several dermatologic conditions including rosacea, atopic dermatitis, and psoriasis. Identifying potential associations between these dermatologic and cardiovascular diseases can better inform holistic healthcare approaches. The objective of this study was to determine whether rosacea, psoriasis or atopic dermatitis are independent risk factors for CVD 1 year following diagnosis.

Methods: Using a large commercial claims database of 21,801,147 lives, we employed a propensity-matched logistic regression to evaluate the association between diagnoses of rosacea, psoriasis, or atopic dermatitis and a 1-year risk of being diagnosed with cardiovascular disease. Control patients were matched based on health-care utilization, age and overall health status as defined by a modified Deyo–Charlson comorbidity index.

Results: The analysis included 2105 rosacea, 622 atopic dermatitis, 1536 psoriasis, and 4263 control patients. Compared to propensity-matched controls, the adjusted odds of cardiovascular disease were not higher in patients with rosacea (odds ratio: 0.894, p = 0.2713), atopic dermatitis (OR 1.032, p = 0.8489), or psoriasis (OR 1.087, p = 0.4210). In univariate analysis, the unadjusted odds of cardiovascular disease was higher in patients with psoriasis (OR 1.223, p = 0.0347).

Conclusions: Limitations of this study include the short follow-up period and inclusion of only commercially insured patients limit the generalizability of these findings. In this large study of patients with rosacea, atopic dermatitis, and psoriasis, we did not detect an increased 1-year risk of cardiovascular disease after adjusting for confounders.

Electronic supplementary material: The online version of this article (doi:10.1007/s13555-016-0144-3) contains supplementary material, which is available to authorized users.

No MeSH data available.


Related in: MedlinePlus