Print This Issue

Penn Medicine Dermatologist: $3.9 Million NIH Grant to Further Understanding of Heart Attack—Psoriasis Link
March 31, 2009, Volume 55, No. 27



Over the next five years, Dr. Joel M. Gelfand, assistant professor of dermatology and associate scholar in the Center of Clinical Epidemiology and Biostatistics at the University of Pennsylvania School of Medicine, will receive funding from the National Institutes of Health’s (NIH) National Heart  Lung and Blood Institute to study the relationship between psoriasis, cardiovascular risk factors and cardiovascular outcomes. This research will build a deeper understanding of the relationship between inflammatory diseases like psoriasis and myocardial infarction (heart attack), potentially paving the way for improved disease management strategies for the over 7 million Americans with psoriasis.

Dr. Gelfand spoke earlier this month at the 67th Annual Meeting of the American Academy of Dermatology in San Francisco. He discussed his ongoing psoriasis research, which has identified an increased risk of developing serious medical conditions, including cardiovascular disease and diabetes, particularly when psoriasis is severe. For more information, please visit www.aad.org/meetings/annual/.

As with other major chronic illnesses, psoriasis can take a toll on patients’ quality of life. The disease is characterized by thick, red, scaly skin plaques which can be localized or widespread and appears as an inflammatory joint disease in some patients.

Affecting over two percent of the adult population in the United States, psoriasis is the most common inflammatory disease categorized by upregulated T helper cell type 1 (Th-1) and Th-17 activity. Increasing evidence has linked this Th-1 and Th-17 inflammation to the development of atherosclerosis and ultimately, myocardial infarction, suggesting that the underlying physiological mechanism that results in psoriasis may also be a risk factor for myocardial infarction. Other Th-1, Th-17 diseases, such as rheumatoid arthritis, have been shown to be independent risk factors for myocardial infarction.

For over 30 years, investigators have suggested that psoriasis may be associated with an increased risk of myocardial infarction. To date, however, there have been no large, broadly representative studies evaluating the impact of psoriasis severity on cardiovascular risk factors and outcomes such as heart attack, stroke, and cardiovascular death. Severity is determined by the extent of body surface area affected by the disease. Previously, Dr. Gelfand’s research has indicated that severe psoriasis patients, as defined by treatment history, may have an increased risk of heart attack, stroke, and death, which is independent of traditional risk factors for these outcomes.

A series of population-based cohort studies will help Dr. Gelfand and his colleagues determine if patients with mild, moderate and severe psoriasis have a higher prevalence of cardiovascular risk factors, poorer control of cardiovascular risk factors, and an increased risk of myocardial infarction, stroke, and cardiovascular mortality compared to patients without psoriasis.


Almanac - March 31, 2009, Volume 55, No. 27