Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study

Kasper Bonnesen; Christian F B Poulsen; Sigrun A J Schmidt; Henrik T Sørensen; Morten Schmidt

doi:10.1016/j.jaad.2024.02.052

Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study

Kasper Bonnesen, Christian F B Poulsen, Sigrun A J Schmidt, Henrik T Sørensen, Morten Schmidt

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

6 Citations (Scopus)

Abstract

BACKGROUND: Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking.

OBJECTIVE: The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.

METHODS: A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195).

RESULTS: Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid.

LIMITATIONS: Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases.

CONCLUSION: Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls.

Original language	English
Journal	Journal of the American Academy of Dermatology
Volume	91
Issue	1
Pages (from-to)	82-90
Number of pages	9
ISSN	0190-9622
DOIs	https://doi.org/10.1016/j.jaad.2024.02.052
Publication status	Published - Jul 2024

Keywords

acute coronary syndrome
angina pectoris
angina, stable
angina, unstable
arrhythmias, cardiac
atrial fibrillation
atrioventricular block
autoimmune diseases
blister
cardiovascular diseases
epidemiology
heart arrest
heart failure
ischemic stroke
myocardial infarction
myocardial revascularization
pemphigoid, bullous
pemphigus
percutaneous coronary intervention
pulmonary embolism
venous thromboembolism
venous thrombosis

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@article{fd8db7e9592349078e96db8d46d5480e,

title = "Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study",

abstract = "BACKGROUND: Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking.OBJECTIVE: The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.METHODS: A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195).RESULTS: Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid.LIMITATIONS: Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases.CONCLUSION: Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls.",

keywords = "acute coronary syndrome, angina pectoris, angina, stable, angina, unstable, arrhythmias, cardiac, atrial fibrillation, atrioventricular block, autoimmune diseases, blister, cardiovascular diseases, epidemiology, heart arrest, heart failure, ischemic stroke, myocardial infarction, myocardial revascularization, pemphigoid, bullous, pemphigus, percutaneous coronary intervention, pulmonary embolism, venous thromboembolism, venous thrombosis",

author = "Kasper Bonnesen and Poulsen, {Christian F B} and Schmidt, {Sigrun A J} and S{\o}rensen, {Henrik T} and Morten Schmidt",

year = "2024",

month = jul,

doi = "10.1016/j.jaad.2024.02.052",

language = "English",

volume = "91",

pages = "82--90",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Elsevier Inc.",

number = "1",

}

Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study. / Bonnesen, Kasper ; Poulsen, Christian F B ; Schmidt, Sigrun A J et al.
In: Journal of the American Academy of Dermatology, Vol. 91, No. 1, 07.2024, p. 82-90.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Autoimmune blistering disorders and cardiovascular risks

T2 - A population-based cohort study

AU - Bonnesen, Kasper

AU - Poulsen, Christian F B

AU - Schmidt, Sigrun A J

AU - Sørensen, Henrik T

AU - Schmidt, Morten

PY - 2024/7

Y1 - 2024/7

N2 - BACKGROUND: Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking.OBJECTIVE: The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.METHODS: A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195).RESULTS: Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid.LIMITATIONS: Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases.CONCLUSION: Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls.

AB - BACKGROUND: Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking.OBJECTIVE: The objective of this study was to examine if ABDs elevate the risk of atherosclerotic cardiovascular disease, heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.METHODS: A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n = 3322) was compared with an age- and sex-matched comparison cohort from the general population (n = 33,195).RESULTS: Compared with the general population, patients with ABDs had higher 1-year risks of atherosclerotic cardiovascular disease (3.4% vs 1.6%), heart failure (1.9% vs 0.7%), arrhythmia (3.8% vs 1.3%), venous thromboembolism (1.9% vs 0.3%), and cardiovascular death (3.3% vs 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABDs with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for atherosclerotic cardiovascular disease, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for venous thromboembolism, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid.LIMITATIONS: Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases.CONCLUSION: Patients with ABDs had an elevated cardiovascular risk compared with age- and sex-matched controls.

KW - acute coronary syndrome

KW - angina pectoris

KW - angina, stable

KW - angina, unstable

KW - arrhythmias, cardiac

KW - atrial fibrillation

KW - atrioventricular block

KW - autoimmune diseases

KW - blister

KW - cardiovascular diseases

KW - epidemiology

KW - heart arrest

KW - heart failure

KW - ischemic stroke

KW - myocardial infarction

KW - myocardial revascularization

KW - pemphigoid, bullous

KW - pemphigus

KW - percutaneous coronary intervention

KW - pulmonary embolism

KW - venous thromboembolism

KW - venous thrombosis

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U2 - 10.1016/j.jaad.2024.02.052

DO - 10.1016/j.jaad.2024.02.052

M3 - Journal article

C2 - 38492858

SN - 0190-9622

VL - 91

SP - 82

EP - 90

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

IS - 1

ER -

Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study

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