Association of psoriasis with myocardial infarction in end-stage renal disease patients

Classic comorbidities include psoriatic arthritis, psychological/psychiatric disorders, and uveitis. Psoriasis patients have a greater prevalence of cardiovascular disease risk factors, including hypertension, diabetes, obesity, dyslipidemia, and atherosclerosis. Psoriasis has also been associated with an increased prevalence of severe coronary artery calcification (CAC), with CAC scores elevated to a similar extent as is observed in type II diabetes. ^, CAC, in turn, is associated with cardiovascular disease, including myocardial infarction (MI). ^, Furthermore, meta-analysis studies have suggested that psoriasis is associated with an increased risk of severe vascular events, particularly MI. ^, Inflammation, secretion of adipokines, insulin resistance, enhanced angiogenesis, oxidative stress, and hypercoagulability may contribute to the association between psoriasis and cardiometabolic disorders. Patients with psoriasis are also at significantly increased risk for chronic kidney disease and end-stage renal disease (ESRD). ^, One possible mechanism proposes that tubular injury may be induced by increased levels of uric acid. ^, In addition, renal dysfunction may potentially be attributed to comorbidities associated with psoriasis, including atherosclerosis, arterial hypertension, and diabetes. Systemic inflammation may also provide a mechanistic link between psoriasis and kidney disease, as well as cardiometabolic disorders. Patients with severe psoriasis were found to have a 5-year decreased life expectancy, with cardiovascular disease contributing significantly to this disparity. ^, Psoriasis patients also showed an increased risk of stroke, atherosclerosis, myocardial infarction, coronary artery disease, and endothelial dysfunction even when cardiovascular risk factors were accounted for. ^, Psoriasis remains undertreated in the ESRD population when compared to the already undertreated general population. Thus, the presence of psoriasis may represent a significant additive risk factor for developing cardiovascular diseases in ESRD patients. To address this question, we queried the United States Renal Data System (USRDS) for ESRD patients with psoriasis to investigate psoriasis as a potential risk factor for myocardial infarction (MI).