Atopic dermatitis is associated with an increased risk of cardiovascular diseases: A large-scale, propensity-score matched US-based retrospective study

Background: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease characterized by intense itch, and impacting heavily on patients' and caregivers' quality of life. Its clinical presentation is accompanied by a variety of comorbidities associated with type 2 inflammation, such as asthma, hay fever and food allergies. However, current data on cardiovascular comorbidities are inconsistent. Objectives: To identify the risk of cardiovascular diseases (CVDs) in patients with AD. Methods: Data from electronic health records of 1 070 965 patients with AD and equally distributed propensity-score matched controls were retrieved from the US Collaborative Network, part of the federated TriNetX network. Hazard ratios (HRs) for the risk of onset of CVDs with a prevalence of ≥ 1% in both cohorts within 20 years after diagnosis were determined. Results: In total, 55 CVDs belonging to 8 major cardiovascular groups were identified. Of those, 53 diagnoses displayed a significantly increased risk in patients with AD. Different diagnoses of heart failure and heart disease were found most often, followed by valve insufficiencies, arrhythmia, tachycardia, atrial fibrillation and flutter, but also major adverse cardiovascular events and venous thromboembolism. The highest HRs were displayed by the individual diagnoses of venous insufficiency, atherosclerosis of native arteries of the extremities, and unspecified diastolic (congestive) heart failure. Conclusions: AD is associated with an increased risk for multiple CVDs.