Objective. To examine the utility of the Framingham risk score (FRS) in estimating cardiovascular risk in psoriasis. Methods. We compared the predicted 10-year risk of cardiovascular events, namely, cardiovascular death, myocardial infarction, heart failure, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting using the FRS, to the observed risk of cardiovascular events in a population-based cohort of patients with psoriasis. Patients with incident or prevalent adult-onset psoriasis aged 30–79 years without prior history of cardiovascular disease were included. Results. Among the 1197 patients with predicted risk scores, the median FRS was 6.0%, while the observed 10-year cardiovascular risk was 6.9% (standardized incidence ratio (SIR): 1.14; 95% confidence interval (CI): 0.92–1.42). The SIR was not elevated for women nor for men. The differences between observed and predicted cardiovascular risks in patients <60 years (SIR: 1.01; 95% CI: 0.73–1.41) or ≥60 years (SIR: 1.26; 95% CI: 0.95–1.68) were not statistically significant. Conclusion. There was no apparent difference between observed and predicted cardiovascular risks in patients with psoriasis in our study. FRS reasonably estimated cardiovascular risk in both men and women as well as in younger and older psoriasis patients, suggesting that FRS can be used in risk stratification in psoriasis without further adjustment. 1. Introduction There is increasing interest in cardiovascular implications of chronic inflammatory conditions such as psoriasis [1]. Epidemiologic observations have demonstrated increased rates of cardiovascular events in patients with psoriasis [2, 3]. Some studies suggested that psoriasis itself may be an independent cardiovascular risk factor [4, 5], while others did not support this finding [6]. It is unclear whether cardiovascular risk in psoriasis is increased beyond that conferred by traditional cardiovascular risk factors and whether traditional risk assessment tools such as the Framingham risk score (FRS) are useful for cardiovascular risk stratification in psoriasis. We aimed to examine the utility of the FRS in estimating cardiovascular risk in psoriasis. 2. Materials and Methods This retrospective population-based study was conducted using the Rochester epidemiology project (REP), a medical records linkage system containing complete inpatient and outpatient records from all healthcare providers in Olmsted County, Minnesota. The unique features of the REP were described previously [7]. The study protocol was approved by the Institutional
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