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Review
. 2022 Nov 1;20(1):421.
doi: 10.1186/s12916-022-02617-5.

Psoriasis and cardiovascular disease risk in European and East Asian populations: evidence from meta-analysis and Mendelian randomization analysis

Liming Zhang  1 , Yuxiang Wang  2 , Li Qiu  3 , Jian Wu  3
Affiliations
Review

Psoriasis and cardiovascular disease risk in European and East Asian populations: evidence from meta-analysis and Mendelian randomization analysis

Liming Zhang et al. BMC Med. .

Abstract

Background: Psoriasis has been linked to cardiovascular disease (CVD), including coronary artery disease (CAD), myocardial infarction (MI), and heart failure (HF). However, available studies regarding this relationship have shown inconsistent results. Therefore, in this report, we performed a comprehensive review of the literature to assess the effects of psoriasis on risk of these CVDs.

Methods: A search of literature until 24 December 2021 was done in PubMed, the Cochrane Library, Web of Science, Google Scholar, and Embase. Within European and East Asian populations, meta-analyses of observational studies assessing correlations between psoriasis and various CVD risk factors were conducted. Mendelian randomization (MR) was then employed to assess the causative impact of genetic pre-disposition for psoriasis on these CVD risk factors.

Results: The results of the meta-analyses indicated that, in both the European and East Asian populations, psoriasis was significantly linked to an elevated risk in the incidence of CAD (RR = 1.51, 95% confidence interval (CI): 1.04-2.18, p = 0.028 and RR = 1.91, 95% CI: 1.62-2.25, p < 0.001) and MI (RR = 1.23, 95% CI: 1.04-1.46, p = 0.017 and RR = 2.17, 95% CI: 1.44-3.28, p < 0.001). A positive genetic relationship of psoriasis with CAD was found in European individuals (IVW OR:1.03; 95% CI: 1.01-1.06, p = 0.005) and in East Asian individuals (IVW OR:1.18; 95% CI: 1.03-1.32, p = 0.031). We also established that psoriasis was causally linked with an elevated risk of MI (IVW OR:1.05; 95% CI: 1.01-1.09, p = 0.026) in the European population as determined using an MR approach. Moreover, our MR results were congruent with the null findings from the meta-analysis assessing associations of psoriasis with HF risk.

Conclusions: This research work provides preliminary evidence that psoriasis and CVD have a common genetic origin and that targeted psoriasis treatment might improve cardiovascular outcomes. These results not only increase our knowledge of the genetic underpinnings linking a comorbidity of psoriasis with CVD but also suggests a novel approach for CVD prevention.

Keywords: Cardiovascular disease; Mendelian randomization; Psoriasis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Schematic diagram illustrating Mendelian randomization assumptions underlining a Mendelian randomization analysis on the relationship of psoriasis with coronary artery disease, myocardial infarction, and heart failure
Fig. 2
Fig. 2
Flow chart illustrating details regarding the literature selection for CAD (a), MI (b), and HF (c). CAD, coronary artery disease; MI, myocardial infarction; HF, heart failure
Fig. 3
Fig. 3
Meta-analyses on the relationship of psoriasis with CAD (a), association between psoriasis and MI (b), and HF (c). CAD, coronary artery disease; MI, myocardial infarction; HF, heart failure
Fig. 4
Fig. 4
GTEx tissue enrichment analysis for expression of psoriasis loci in European (a) and East Asian (b) populations
See this image and copyright information in PMC

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