Role of psoriasis as independent predictor of cardiovascular disease: A meta-regression analysis

Background: Despite the proved association between psoriasis and cardiovascular risk exposure, there are no data about the role of psoriasis as an independent predictor of such risk. The aim of this study was to investigate whether any association between psoriasis and excess cardiovascular risk exposure is independent from confounding factors. Methods: Meta-analysis and meta-regression analysis were performed using data extracted from observational studies (identified by MEDLINE, EMBASE and CINAHL) investigating the relationship between psoriasis and cardiovascular disease with at least 6 points on the New Castle-Ottawa quality scale. Two reviewers with methodological expertise conducted data extraction independently. Results: Thirteen studies including patients with psoriasis showed an increased risk of cardiovascular disease (RR=1.24 [1.18-1.31]; P=0.0001). These patients still presented a significantly larger cardiovascular risk in the presence of smoking (RR=1.14 [CI=1.13-1.15] P<0.0001), obesity (RR=1.11 [CI=1.07-1.14] P=0.0003) and hyperlipidemia (RR=1.05 [CI=1.03-1.07] P=0.0006), but not in the presence of hypertension (RR=1.03 [CI=0.98-1.09] P=0.4647) and diabetes (RR=0.95 [CI=0.90-1.01] P=0.6502). Conclusions: Patients with psoriasis carry an about 25% increased relative risk of cardiovascular disease. This risk appears to be independent of smoking, obesity and hyperlipidemia. (C) 2013 Elsevier Ireland Ltd. All rights reserved.