Background: Severe psoriasis increases cardiovascular risk but there is limited data comparing overall mortality and outcomes in AMI (acute myocardial infarction) patients with versus without Psoriasis. The objective of our study is to compare the outcomes and the predictors of mortality between 2 groups.
Methods: The National Inpatient Sample (NIS) is an all-payer inpatient database in the US which contains more than 15 million weighted discharges every year. We queried NIS database 2014 for AMI using ICD-9 CM diagnostic code 410. Of these, ICD-9 CM codes 696.0 and 696.1 were used to identify Psoriasis patients. Discharge weights were used to calculate national estimates. Using SPSS 22, demographics and independent predictors were analyzed using chi–square test and multivariable binary logistic regression model.
Results: We identified 118,159 in-hospital AMI patients in 2014. Of these, 658 Psoriasis patients were identified. Overall mortality was lower in Psoriasis group (3.3% vs. 5%) (p<0.001). Co-morbidities were more prevalent in Psoriasis group (<0.001) (Table1). The risk of mortality in AMI with psoriasis group was higher with diabetes (OR 2.116, 95% CI 1.25 – 3.58, P=0.005), dysrhythmias (OR 7.537, 95% CI 4.13 – 13.75, P<0.001), coronary atherosclerosis (OR 2.517 95% CI 1.01 – 6.26, P=0.047) and other neurological disorders (OR 3.713, 95% CI 1.82 – 7.55, P <0.001) (Table 2).
Conclusion: Our study showed lower overall mortality in spite of the higher prevalence of comorbidities in AMI patients having Psoriasis which may be reflective of larger pool of mild Psoriasis cases compared to severe ones. Preventive strides to bring down comorbidities can get us even better results.