Patients who are diagnosed with severe atopic dermatitis (AD) are at an increased risk for major cardiovascular (CV) events but not mortality, according to research presented at the 2022 AAD annual meeting.

“[AD] is a systemic inflammatory disorder that may increase risk for [CV] events, but data are limited, particularly in children,” the researchers explained.

To better quantify the risk of CV events and all-cause mortality in AD patients, the study authors performed a population-based cohort study using a UK-based electronic medical records database from 1994 to 2015.

They identified 625,083 adults, 18 years and older, and 409,431 children, under the age of 18 with AD. The study participants were respectively matched on age, practice, and index date to 2,678,888 adult and 1,809,029 pediatric unaffected controls.

“In adults, we observed an association between AD and stroke (HR 1.04 [1.02-1.06]), particularly among those with severe AD (HR 1.21 [1.13-1.30]). Severe AD was associated with an increased risk of [myocardial infarction (MI)](HR 1.27 [1.15-1.39]) while no difference was detected for mild or moderate AD,” the study authors wrote.

Additonal findings suggest the risk of death was increased among patients with mild AD (HR 1.13 [1.12-1.14]), however, it was lower among those with moderate (HR 0.90 [0.89-0.91]) and at unity in severe AD (HR 0.99 [0.94-1.03]) in comparison to non-AD controls.

For the child participants, severe AD was associated with greater risk of stroke (HR 2.43 [1.13-5.22]), and the research team reported that there was no associated between pediatric AD and MI (HR 0.75 [0.28-1.99]).

Finally, compared with the non-AD control group, there was a lower risk of death among children with AD—particularly among those with mild or moderate disease (HRs 0.75 [0.66-0.85] and 0.48 [0.33-0.70], respectively).

“In conclusion, severe AD appeared to be associated with increased risk of several major CV events but not mortality, supporting the need for additional investigation into this relationship, as this is critical in understanding natural history of disease,” the authors concluded.

Reference:

Syed MN, Shin DB, Wan J, et al. Risk of cardiovascular events and all cause mortality in patients with atopic dermatitis: a population-based cohort study. Presented at: AAD Annual Meeting; March 25-28, 2022; Boston, MA.