Psoriasis impacts ap – proximately 7.5 million adults in the United States, or 3% of the population. It is associated with an increased risk for develop – ing several conditions such as metabolic syndrome, hypertension, and diabetes, among others. In a recent systematic review published in Current Problems in Cardiology, Hritvik Jain, MBBS, and col – leagues sought to better understand the link between psoriasis and atrial fibrillation (AF).
“Recent research has uncovered an associ – ation between psoriasis and AF, the most common arrhythmia in clinical practice. AF has been increasingly demonstrated to have inflammatory components in its patho – physiology. Since AF is associated with a heightened risk of mortality, early detection and treatment of AF is the cornerstone for reducing poor outcomes,” Jain and coauthors wrote.
The authors’ initial search yielded 253 articles. After removing duplicates and screening for inclusion criteria, their review included seven studies involving 10,974,668 participants (194,230 with psoriasis and 10,780,439 controls).
Their results indicated that patients with psoriasis have a significantly higher risk of AF (pooled HR, 1.28; 95% CI, 1.20-1.36; P<0.00001). Subgroup analysis revealed that patients with severe psoriasis have a slightly higher AF risk (HR, 1.32; 95% CI, 1.23- 1.42; P<0.001) compared with patients who have mild psoriasis (HR, 1.21; 95% CI, 1.10-1.33; P<0.001), though the differ – ence was not statistically significant ( P=0.17). The researchers did not detect any significant publication bias (P=0.24).
The researchers advised that their results should be interpretated with caution, as there was high heterogeneity between the studies included in the review. Nevertheless, they recommended further research and suggested that clinicians screen for AF in patients with psoriasis.
“Patients with psoriasis are at an increased risk of AF development; hence, they should be closely monitored to detect AF early. Since the current literature associating pso – riasis and AF consists of only observational studies, multicenter, large-scale randomized studies should be conducted to validate the robustness of these findings,” Jain and coauthors concluded