The Risk of Myocardial Infarction in Patients with Psoriasis

银屑病患者发生心肌梗死的风险

• 批准号: 8442932
• 负责人: JOEL M GELFAND
• 金额: $ 64.9万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8442932
• 关键词: Adult; Affect; American; Atherosclerosis; Autoimmune Diseases; Blood; Blood Pressure; Body Surface Area; Body mass index; CD4 Positive T Lymphocytes; Cardiovascular Diseases; Cardiovascular system; Caring; Cessation of life; Cholesterol; Chronic Disease; Cohort Studies; Confounding Factors (Epidemiology); Cross-Sectional Studies; Data; Databases; Development; Diabetes Mellitus; Diagnosis; Disease; Event; Functional disorder; Health; Helper-Inducer T-Lymphocyte; Hemoglobin concentration result; High Prevalence; Hyperlipidemia; Hypertension; Immune system; Inflammation; Inflammatory; Ischemic Stroke; Laboratories; Lead; Link; Measurement; Measures; Medical Records; Methods; Modeling; Myocardial Infarction; Outcome; Pathogenesis; Pathology; Pathway interactions; Patients; Play; Population; Prevalence; Psoriasis; Public Health; Publishing; Reporting; Research Personnel; Rheumatoid Arthritis; Risk; Risk Factors; Role; Series; Severities; Skin; Skin Plaques; Smoking; Stroke; System; T-Lymphocyte; Testing; Th1 Cells; Thick; Tumor Necrosis Factor-alpha; United Kingdom; arthropathies; base; cardiovascular risk factor; cytokine; health related quality of life; high risk; improved; innovation; mortality; population based; prospective

DESCRIPTION (provided by applicant): Psoriasis is the most common T helper cell type 1 (Th-1) autoimmune disease, affecting over 2% of the adult population. Similar to other major chronic illnesses, psoriasis is associated with significant decrements in health related quality of life. Psoriasis is characterized by thick, red, scaly skin plaques which can be localized or widespread and an inflammatory arthropathy in some patients. For over 30 years, investigators have suggested that psoriasis may be associated with an increased risk of myocardial infarction, however, there have been no studies evaluating this association using population-based methods and multivariable analysis to control for potential confounding variables. We have developed compelling preliminary data that psoriasis may be an independent risk factor for developing MI. Increasing evidence has linked Th-1 inflammatory pathways to the development of atherosclerosis and ultimately, myocardial infarction, suggesting that the pathophysiology of psoriasis may confer an independent risk for myocardial infarction. In fact, other Th-1 diseases, such as rheumatoid arthritis, have been shown to be independent risk factors for myocardial infarction. We propose to conduct a series of population-based cohort studies to determine if patients with psoriasis have a higher prevalence of cardiovascular risk factors, poorer control of cardiovascular risk factors, and an increased risk of myocardial infarction, stroke, and cardiovascular mortality compared to patients without psoriasis. Studying the relationship between psoriasis, cardiovascular risk factors, and cardiovascular outcomes will have important implications as to our understanding of the relationship between inflammatory diseases and myocardial infarction and will have potentially important public health implications for the care of the over 7 million US patients with psoriasis.

描述（由申请人提供）：牛皮癣是最常见的辅助性T细胞1型（Th-1）自身免疫性疾病，影响超过2%的成年人。与其他主要慢性疾病类似，牛皮癣与健康相关的生活质量显著下降有关。银屑病的特点是厚的、红色的、鳞状的皮肤斑块，可以是局部的或广泛的，在一些患者中有炎症性关节病。30多年来，研究人员一直认为牛皮癣可能与心肌梗死风险增加有关，然而，尚未有研究使用基于人群的方法和多变量分析来评估这种关联，以控制潜在的混杂变量。我们已经获得了令人信服的初步数据，表明银屑病可能是发生心肌梗死的独立危险因素。越来越多的证据表明，Th-1炎症途径与动脉粥样硬化的发展以及最终的心肌梗死有关，这表明银屑病的病理生理可能会导致心肌梗死的独立风险。事实上，其他Th-1疾病，如类风湿关节炎，已被证明是心肌梗死的独立危险因素。我们建议开展一系列以人群为基础的队列研究，以确定牛皮癣患者是否具有更高的心血管危险因素患病率、较差的心血管危险因素控制、心肌梗死、卒中和心血管死亡率的风险比无牛皮癣患者高。研究牛皮癣、心血管危险因素和心血管结局之间的关系将对我们理解炎症性疾病和心肌梗死之间的关系具有重要意义，并对700多万美国牛皮癣患者的护理具有潜在的重要公共卫生意义。

项目成果

High-density lipoprotein cholesterol function improves after successful treatment of psoriasis: a step forward in the right direction.

• DOI: 10.1038/jid.2013.447
• 发表时间: 2014-03
• 期刊: JOURNAL OF INVESTIGATIVE DERMATOLOGY
• 影响因子: 6.5
• 作者: Mehta, Nehal N.;Gelfand, Joel M.
• 通讯作者: Gelfand, Joel M.

Assessing long-term drug safety: lessons (re) learned from raptiva.

评估长期药物安全性：从 raptiva 中（重新）吸取的教训。

• DOI: 10.1016/j.sder.2010.01.001
• 发表时间: 2010
• 期刊: Seminars in cutaneous medicine and surgery
• 作者: Seminara,NicoleM;Gelfand,JoelM
• 通讯作者: Gelfand,JoelM

Metabolic syndrome in patients with psoriatic disease.

• DOI: 10.3899/jrheum.120237
• 发表时间: 2012-07
• 期刊: The Journal of rheumatology. Supplement
• 作者: Gelfand JM;Yeung H
• 通讯作者: Yeung H

Effect of psoriasis severity on hypertension control: a population-based study in the United Kingdom.

• DOI: 10.1001/jamadermatol.2014.2094
• 发表时间: 2015-02
• 期刊: JAMA dermatology
• 影响因子: 10.9
• 作者: Takeshita J;Wang S;Shin DB;Mehta NN;Kimmel SE;Margolis DJ;Troxel AB;Gelfand JM
• 通讯作者: Gelfand JM

Counterpoint: A tale of two meta-analyses revisited.

对位：重新审视两项荟萃分析的故事。

• DOI: 10.1016/j.jaad.2013.10.053
• 发表时间: 2014
• 期刊: Journal of the American Academy of Dermatology
• 影响因子: 13.8
• 作者: Dommasch,EricaD;Troxel,AndreaB;Gelfand,JoelM
• 通讯作者: Gelfand,JoelM