Psoriasis and risk of new-onset degenerative valvular heart disease: a prospective cohort study

Abstract Background Recent evidence indicates that degenerative valvular heart disease (VHD) and psoriasis share overlapping risk factors and simultaneous presence of inflammation, yet this relationship has not been thoroughly explored. Methods and results Drawing on the prospective cohort data from the UK Biobank, baseline information on psoriasis and the incidence of eight specific types of degenerative VHD—aortic stenosis (AS), aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid stenosis, tricuspid regurgitation, pulmonary stenosis, and pulmonary regurgitation—during the follow-up period were recorded. Cox proportional hazards models were conducted to estimate the association between psoriasis and the risk of degenerative VHD, adjusted for demographic indicators, lifestyle factors, comorbidities, and medication. A total of 494 510 participants were included in the study. Among the participants without psoriasis, 13 672 events of degenerative VHD were observed during a median follow-up of 13.78 years, yielding an incidence rate of 2.14 per 1000 person-years. In contrast, in the psoriasis group (n = 10 917), 422 events of degenerative VHD were reported during a median follow-up of 13.70 years, corresponding to an incidence rate of 2.93 per 1000 person-years. After fully adjusting, participants with psoriasis had a significantly increased risk of AS (hazard ratio, 1.24; 95% confidence interval, 1.07–1.43), yet no significant associations were observed between psoriasis and the risk of other degenerative valve diseases. In sex subgroup analyses, there was an interaction between sex and psoriasis in the occurrence of AS (P for interaction = 0.039), suggesting a high risk in women. Conclusions Psoriasis was significantly associated with the risk of new-onset AS and may be more distinct in females, while no significant associations were observed between psoriasis and the risk of developing other degenerative valve diseases.