The cardiovascular risk in bullous pemphigoid: Insights from a population-based study

IF 2.2 4区医学 Q2 DERMATOLOGY

Australasian Journal of Dermatology Pub Date : 2024-08-01 DOI:10.1111/ajd.14355

Khalaf Kridin PhD, Rina Goychberg BSc, Mouhammad Kridin MD, Niv Kafri BSc, Masad Barhoum MHA, Arnon D. Cohen PhD

{"title":"The cardiovascular risk in bullous pemphigoid: Insights from a population-based study","authors":"Khalaf Kridin PhD, Rina Goychberg BSc, Mouhammad Kridin MD, Niv Kafri BSc, Masad Barhoum MHA, Arnon D. Cohen PhD","doi":"10.1111/ajd.14355","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The risk of life-threatening major cardiovascular outcomes among patients with bullous pemphigoid (BP) is inconsistent in the current literature.</p>\n </section>\n \n <section>\n \n <h3> Objective</h3>\n \n <p>To evaluate the risk and prognostic outcomes of myocardial infarction (MI), cerebrovascular accident (CVA), peripheral vascular disease (PVD) and pulmonary embolism (PE) in patients with BP. We additionally aimed to explore the influence of different therapeutic approaches on the risk of these outcomes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A population-based retrospective cohort study was conducted to compare BP patients (<i>n</i> = 3924) with age-, gender- and ethnicity-matched control subjects (<i>n</i> = 19,280) with regard to incident cases of MI, CVA, PVD and PE. Adjusted hazard ratio (HR) and 95% confidence intervals (CI) were estimated by multivariate Cox regression analysis. Data were retrieved from Clalit Health Services' computerized database.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Relative to their matched controls, patients with BP were at an elevated risk of MI (fully-adjusted HR: 1.44; 95% CI: 1.14–1.81; <i>p</i> = 0.002), CVA (fully-adjusted HR: 1.24; 95% CI: 1.06–1.45; <i>p</i> = 0.007), PVD (fully-adjusted HR: 1.60; 95% CI: 1.27–2.03; <i>p</i> = 0.003) and PE (fully-adjusted HR: 1.72; 95% CI: 1.28–2.32; <i>p</i> < 0.008). Patients with BP experienced heightened risk of all-cause mortality in the presence of comorbid MI (fully-adjusted HR: 1.61; 95% CI: 1.44–1.81; <i>p</i> < 0.001), CVA (fully-adjusted HR: 1.70; 95% CI: 1.52–1.89; <i>p</i> < 0.001), PVD (fully-adjusted HR: 1.38; 95% CI: 1.20–1.58; <i>p</i> < 0.001) and PE (fully-adjusted HR: 1.44; 95% CI: 1.10–1.88; <i>p</i> = 0.007). The therapeutic approach utilized to manage BP did not significantly influence the risk of cardiovascular outcomes.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>BP is associated with an elevated risk of MI, CVA, PVD, PE and cardiovascular mortality. Primary, secondary and tertiary cardiovascular prevention measures should be implemented among patients with BP.</p>\n </section>\n </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e187-e193"},"PeriodicalIF":2.2000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14355","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australasian Journal of Dermatology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajd.14355","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The risk of life-threatening major cardiovascular outcomes among patients with bullous pemphigoid (BP) is inconsistent in the current literature.

Objective

To evaluate the risk and prognostic outcomes of myocardial infarction (MI), cerebrovascular accident (CVA), peripheral vascular disease (PVD) and pulmonary embolism (PE) in patients with BP. We additionally aimed to explore the influence of different therapeutic approaches on the risk of these outcomes.

Methods

A population-based retrospective cohort study was conducted to compare BP patients (n = 3924) with age-, gender- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of MI, CVA, PVD and PE. Adjusted hazard ratio (HR) and 95% confidence intervals (CI) were estimated by multivariate Cox regression analysis. Data were retrieved from Clalit Health Services' computerized database.

Results

Relative to their matched controls, patients with BP were at an elevated risk of MI (fully-adjusted HR: 1.44; 95% CI: 1.14–1.81; p = 0.002), CVA (fully-adjusted HR: 1.24; 95% CI: 1.06–1.45; p = 0.007), PVD (fully-adjusted HR: 1.60; 95% CI: 1.27–2.03; p = 0.003) and PE (fully-adjusted HR: 1.72; 95% CI: 1.28–2.32; p < 0.008). Patients with BP experienced heightened risk of all-cause mortality in the presence of comorbid MI (fully-adjusted HR: 1.61; 95% CI: 1.44–1.81; p < 0.001), CVA (fully-adjusted HR: 1.70; 95% CI: 1.52–1.89; p < 0.001), PVD (fully-adjusted HR: 1.38; 95% CI: 1.20–1.58; p < 0.001) and PE (fully-adjusted HR: 1.44; 95% CI: 1.10–1.88; p = 0.007). The therapeutic approach utilized to manage BP did not significantly influence the risk of cardiovascular outcomes.

Conclusions

BP is associated with an elevated risk of MI, CVA, PVD, PE and cardiovascular mortality. Primary, secondary and tertiary cardiovascular prevention measures should be implemented among patients with BP.

查看原文本刊更多论文

大疱性类天疱疮的心血管风险：一项人群研究的启示。

背景：关于大疱性类天疱疮（BP）患者危及生命的主要心血管后果的风险，目前的文献并不一致：关于大疱性类天疱疮（BP）患者发生危及生命的主要心血管疾病的风险，目前的文献报道并不一致：目的：评估大疱性类天疱疮患者发生心肌梗死（MI）、脑血管意外（CVA）、外周血管疾病（PVD）和肺栓塞（PE）的风险和预后结果。此外，我们还旨在探讨不同治疗方法对这些后果风险的影响：我们进行了一项基于人群的回顾性队列研究，比较了血压患者（n = 3924）与年龄、性别和种族匹配的对照组（n = 19280）在心肌梗死、脑梗死、心血管疾病和肺栓塞方面的发病情况。通过多变量考克斯回归分析估算了调整后的危险比（HR）和 95% 的置信区间（CI）。数据取自 Clalit Health Services 的计算机数据库：与匹配的对照组相比，血压患者发生心肌梗死（完全调整后 HR：1.44；95% CI：1.14-1.81；P = 0.002）、脑梗死（完全调整后 HR：1.24；95% CI：1.06-1.45；p = 0.007）、PVD（完全调整 HR：1.60；95% CI：1.27-2.03；p = 0.003）和 PE（完全调整 HR：1.72；95% CI：1.28-2.32；p 结论：血压与 MI、CVA、PVD、PE 和心血管死亡风险升高有关。应对血压患者采取一级、二级和三级心血管预防措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Australasian Journal of Dermatology 医学-皮肤病学

CiteScore

3.20

自引率

5.00%

发文量

186

审稿时长

6-12 weeks

期刊介绍： Australasian Journal of Dermatology is the official journal of the Australasian College of Dermatologists and the New Zealand Dermatological Society, publishing peer-reviewed, original research articles, reviews and case reports dealing with all aspects of clinical practice and research in dermatology. Clinical presentations, medical and physical therapies and investigations, including dermatopathology and mycology, are covered. Short articles may be published under the headings ‘Signs, Syndromes and Diagnoses’, ‘Dermatopathology Presentation’, ‘Vignettes in Contact Dermatology’, ‘Surgery Corner’ or ‘Letters to the Editor’.