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Congestive Heart Failure in the Psoriasis Population

Cardiovascular risk factors and the incidence of cardiovascular events have been described in patients with psoriasis (PsO).¹⁵⁶⁵  In a study of the IMS Health and MarketScan claims database covering January 2001 to December 2002, Kimball, et al.,¹¹⁷⁶¹  investigated the prevalence of cardiovascular disease. In a sample representative of the US adult population, PsO patients were selected by ICD-9 diagnosis codes and matched with controls in a 3:1 ratio. Psoriatic arthritis was classified as a subtype of arthritis. Patients were grouped as having severe PsO if they had received at least 1 systemic treatment during the study period. Patients diagnosed with PsO without having received systemic treatment were classified as mild PsO. Traditional risk factors (obesity, hypertension, diabetes mellitus) for congestive heart failure (CHF) were identified by ICD-9 codes and captured for analysis of potential confounding factors.

A greater prevalence of cardiovascular disease was observed in the PsO arms of both databases. After adjustments for age differential (patients in the IMS Health group were on average younger than those in the HealthScan group), CHF prevalence was 4.2% (OR 1.21, 95% CI: 1.12-1.30) in the MarketScan dataset and 1.9% (OR 1.22, 95% CI: 1.10-1.35) in the IMS Health group. Moreover, CHF prevalence correlated significantly with the degree of PsO severity, measured by treatment intensity. Patients with mild psoriatic disease had an odds ratio of 1.17 for CHF in both datasets, whereas those with severe disease had an odds ratio of 1.39 MarketScan (95% CI: 1.17-1.64) and 1.57 IMS Health (95% CI: 1.26-1.96).

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