In-hospital isolated coronary artery bypass grafting outcomes in patients with psoriasis: a population-based National Inpatient Sample study from 2015-2021.

Abstract

Background: Psoriasis is a chronic skin disease that shares common inflammatory pathways with atherosclerosis. Although psoriasis is known to increase risk of developing coronary artery disease, the impact of psoriasis on outcomes after coronary artery bypass grafting (CABG) remains less established. This study aimed to compare the in-hospital outcomes of isolated CABG between patients with and without psoriasis through a population-based analysis of a national database.

Methods: Patients underwent CABG were selected from National Inpatient Sample from Q4 2015-2021. Patients with age <18 years and concomitant procedures were excluded. A 1:2 propensity-score matching was used to match demographics, socioeconomic status, primary payer status, hospital characteristics, comorbidities, and transfer/admission status between psoriasis and non-psoriasis patients. In-hospital outcomes were assessed.

Results: There were 1,732 (0.95%) patients who underwent isolated CABG who had psoriasis. Patients with psoriasis were younger and more socioeconomically advantaged. After propensity-score matched to 3598 out of 191,175 non-psoriasis patients, patients with and without psoriasis had comparable in-hospital mortality rates (1.39% vs 1.03%, p = 0.27) and major adverse cardiovascular event (1.45% vs 1.86%, p = 0.31). Psoriasis patients had a slightly lower risk of venous thromboembolism (0.23% vs 0.67%, p = 0.04). All other in-hospital outcomes were comparable between psoriasis and non-psoriasis patients.

Conclusions: The representation of psoriasis patients in CABG was lower than their prevalence in the general population. After propensity-score matching, outcomes for patients with and without psoriasis were comparable. Thus, despite the elevated cardiovascular risks associated with psoriasis, CABG may be as safe and as effective for these patients.