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Dermatology
Research
Hospital-diagnosed atopic dermatitis and long-term risk of myocardial infarction: a population-based follow-up study
  1. Jette Lindorff Riis1,
  2. Christian Vestergaard1,
  3. Kasper Fjellhaugen Hjuler1,
  4. Lars Iversen1,
  5. Lars Jakobsen2,
  6. Mette S Deleuran1,
  7. Morten Olsen3
  1. 1Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
  3. 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Dr Jette Lindorff Riis; jette_riis{at}hotmail.com

Abstract

Objective Atopic dermatitis (AD) is an inflammatory skin disorder with a childhood prevalence reaching 20%. An estimated 50% of patients have a life-long chronic course. The purpose of this study was to estimate the risk of first-time myocardial infarction (MI) in patients with AD compared with a general population cohort.

Design Cohort study.

Setting Denmark.

Participants Using population-based medical registries, we identified individuals born in Denmark from 1947 to 1983 with at least two hospital-diagnoses of AD following inpatient admissions or hospital-based outpatient visits at any age from 1977 to 2013. Individuals with AD were matched with general population controls (10:1) for birth-year and gender. Unique personal identifiers permitted unambiguous data linkage.

Primary outcome measures Follow-up began on the date of AD diagnosis (index date for general population controls) and continued until death, emigration, MI or the year 2013. We computed the 15-year-cumulative incidence of MI following a diagnosis of AD. Comparing patients with AD with the general population cohort, we computed HRs of MI presented with 95% CIs and adjusted for history of diabetes mellitus, hypertension, hyperlipidaemia or stroke, educational level, birth-year and sex.

Results We identified 4814 patients diagnosed with AD. The cumulative incidence of MI was 0.6% for patients with AD and 0.4% for their matched controls. The corresponding adjusted HR was 1.74 (1.21 to 2.49). The HR for patients who were not in need of systemic treatment was 1.58 (1.02 to 2.45) and it was 2.40 (1.27 to 4.45) for those who were treated with azathioprine, methotrexate or cyclosporine.

Conclusions Hospital-diagnosed AD was associated with increased risk of MI compared with the general population.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-011870

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    Footnotes

    • Contributors JLR made primary contribution to writing the manuscript. All authors contributed to the study conception and study design. MO performed data collection and statistical analyses and commented on the manuscript. All authors contributed to the interpretation of results, all revised the manuscript critically and all approved the final manuscript. MO is guarantor for this study.

    • Funding This study was supported by grants from the Aage Bang Foundation. The foundation played no role in the conduct of the research.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.