Psoriasis y enfermedad arterial coronaria isquémica / Psoriasis and Ischemic Coronary Artery Disease

INTRODUCCIÓN: La psoriasis es una enfermedad inflamatoria crónica que se ha asociado a un aumento de riesgo de enfermedad arterial coronaria isquémica (EACI) en algunas poblaciones. El objetivo de nuestro estudio fue determinar la asociación entre psoriasis y EACI en nuestro medio. MATERIAL Y MÉTODO: Se realizó un estudio transversal en la provincia de Castellón con datos procedentes del sistema de información asistencial Abucasis (Datamart) desde el año 2005 hasta el 2012. Se seleccionó a los pacientes con psoriasis y como grupo control a los pacientes con nevus melanocítico. Se estudió la prevalencia de EACI en ambos grupos estratificando por los principales factores de riesgo cardiovascular. RESULTADOS: Se estudiaron 9.181 pacientes con psoriasis y 21.925 con nevus melanocítico. En el análisis de regresión logística univariante la EACI se asoció significativamente a las variables psoriasis, edad (en años), sexo, hipertensión, diabetes mellitus, dislipidemia y obesidad (p < 0,05). En el análisis de regresión logística multivariante, tras ajustar por edad, sexo y el resto de los factores de riesgo cardiovascular, se establece una relación independiente entre la presencia de EACI y psoriasis (p < 0,029). CONCLUSIÓN: Nuestros resultados apoyan la existencia de mayor riesgo de EACI en pacientes con psoriasis en una población amplia del área mediterránea

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with an increased risk of ischemic coronary artery disease (CAD) in some populations. We aimed to determine the association between these 2 diseases in our geographic area. MATERIAL AND METHOD: We performed a cross-sectional study of patient records between 2005 and 2012 in the database (Abucacis, Datamart) that contains all medical case histories in the province of Castellón, Spain. Patients diagnosed with psoriasis were compared with a control group of patients diagnosed with melanocytic nevus. The prevalence of CAD and the presence or absence of the main cardiovascular risk factors were analyzed in each group. RESULTS: A total of 9181 patients with psoriasis and 21925 with melanocytic nevus were studied. Univariate logistic regression analysis showed that CAD was significantly associated with psoriasis, age (in years), sex, hypertension, diabetes mellitus, dyslipidemia, and obesity (P < .05). On adjustment for age, sex, and the other cardiovascular risk factors, multivariate regression analysis established that psoriasis was independently associated with CAD (P < .029). CONCLUSION: Our findings in a large sample of patients in a Mediterranean area support the hypothesis that patients in this population have an increased risk of ischemic CAD

Psoriasis and ischemic coronary artery disease.

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with an increased risk of ischemic coronary artery disease (CAD) in some populations. We aimed to determine the association between these 2 diseases in our geographic area. MATERIAL AND METHOD: We performed a cross-sectional study of patient records between 2005 and 2012 in the database (Abucacis, Datamart) that contains all medical case histories in the province of Castellón, Spain. Patients diagnosed with psoriasis were compared with a control group of patients diagnosed with melanocytic nevus. The prevalence of CAD and the presence or absence of the main cardiovascular risk factors were analyzed in each group. RESULTS: A total of 9181 patients with psoriasis and 21925 with melanocytic nevus were studied. Univariate logistic regression analysis showed that CAD was significantly associated with psoriasis, age (in years), sex, hypertension, diabetes mellitus, dyslipidemia, and obesity (P<.05). On adjustment for age, sex, and the other cardiovascular risk factors, multivariate regression analysis established that psoriasis was independently associated with CAD (P<.029). CONCLUSION: Our findings in a large sample of patients in a Mediterranean area support the hypothesis that patients in this population have an increased risk of ischemic CAD.

Group A streptococcal bacteremia: outcome and prognostic factors.

In the last two decades, an increase in the incidence of invasive group A streptococcus (GAS) infections has been reported. The aim of this study was to determine the clinical and epidemiological characteristics and the natural history of GAS bacteremias at our hospital by performing a retrospective study of all cases of GAS bacteremia diagnosed at our University hospital from 1994 to 2003. We reported 42 cases of GAS bacteremia (27 men, mean age 42.3 +/- 31.6 years). None had more than one episode and four cases were nosocomial. The mean annual incidence rate was 1.01 cases per 100,000 population. An increase in the incidence but not in severity of GAS bacteremia was observed in the last 5-year period (p<0.001). The rates were highest in young children and the elderly and those with underlying medical conditions; 73.8% of patients had some underlying chronic illness, and the most relevant conditions included peripheral vascular disease and diabetes mellitus. Mortality was high and the worst outcome corresponded to elderly patients with streptococcal toxic shock syndrome (STSS). Thirty patients (71.4%) had a disruption in the integrity of the skin barrier, 14 (33.3%) were immunocompromised patients and 6 patients (14.3%) were intravenous drug users. A source of the bacteremia was noted in 38 patients (90.5%), with skin and soft tissue infection being the major portals of entry. Twelve patients (28.6%) fulfilled the STSS criteria. All strains were susceptible to penicillin and vancomycin. Resistance to erythromycin was 21.4% and to ciprofloxacin was 17.5%. The global mortality rate was 28.6%. Only STSS was significantly associated with increased mortality in the multivariate analysis.