Association between psoriasis and atrial fibrillation: A Systematic review and meta-analysis

Psoriasis is a prevalent inflammatory skin condition characterized by erythematous plaques with scaling. Recent research has demonstrated an increased risk of cardiovascular diseases in patients with psoriasis; however, current evidence on atrial fibrillation (AF) risk in psoriasis is limited. A systematic literature search was performed on major bibliographic databases to retrieve studies that evaluated AF risk in patients with psoriasis. The DerSimonian and Laird random effects model was used to pool the hazard ratios (HR) with 95% confidence intervals (CI). Subgroup analysis was conducted by dividing the patients into mild and severe psoriasis groups. Publication bias was assessed by visual inspection and Egger's regression test. Statistical significance was set at p<0.05. Seven studies were included, with 10,974,668 participants (1,94,230 in the psoriasis group and 10,780,439 in the control group). Patients with psoriasis had a significantly higher risk of AF [Pooled HR: 1.28; 95% CI: 1.20, 1.36; p<0.00001]. In subgroup analysis, patients with severe psoriasis [HR: 1.32; 95% CI: 1.23, 1.42; p<0.00001] demonstrated a slightly higher risk of AF, although statistically insignificant (p=0.17), than the mild psoriasis group [HR: 1.21; 95% CI: 1.10, 1.33; p<0.0001]. Egger's regression test showed no statistically significant publication bias (p=0.24). Our analysis demonstrated that patients with psoriasis are at a significantly higher risk of AF and hence should be closely monitored for AF. Further large-scale and multicenter randomized trials are warranted to validate the robustness of our findings.