Risk of aortic aneurysm in patients with psoriasis: a systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Objective Psoriasis is a chronic inflammatory disease that may play a role in the pathogenesis of atherosclerotic vascular diseases. We conducted this systematic review to investigate the association between psoriasis and the risk of aortic aneurysm. Methods Pubmed, Embase, and Scopus were searched up to July 20, 2019. We included cohort studies if they reported estimate effects assessing the association between having psoriasis and aortic aneurysm. We used Newcastle-Ottawa Scale to evaluate methodology quality of eligible studies. Random-effect meta-analyses were used to pool individual estimates. Subgroup analyses were conducted to find heterogeneity source. Results After a view of 2207 citations, we included three large cohort studies enrolling 5,706,525 participants in this systematic review. Psoriasis patients have an increased risk of development of aortic aneurysm (hazard ratio [HR]: 1.30, 95%confidence intervals [CI], 1.10 to 1.55, I 2 = 53.1%). However, the risk of AA was not significantly increased in female psoriasis patients (HR, 1.55, 95%CI, 0.65 to 3.72), patients with hypertension (HR, 1.44, 95%CI, 0.85 to 2.42), patients with hyperlipidemia (HR, 1.69, 95%CI, 1.15 to 2.48) and patients with diabetes (HR, 1.15, 95%CI 0.46 to 2.87). Conclusions Current evidence from observational studies suggests that psoriasis may increase the risk of aortic aneurysm, and screening of aortic aneurysm might be considered among psoriasis patients. Key questions What is already known on this subject? Patients with psoriasis have an increased prevalence of cardiovascular diseases, including ischemic heart disease, heart failure, peripheral vascular disease and stroke. The increased risk of cardiovascular events is believed to be associated with the systematic inflammatory pathophysiological mechanisms of psoriasis. What might this study add? This systematic review and meta-analysis summarized epidemiological evidence investigating the relationship between psoriasis and aortic aneurysm, and we found psoriasis patients have an increased risk of aortic aneurysm. How might this impact on clinical practice? Screening for aortic aneurysm could be conducted among psoriasis patients, and the anti-inflammatory therapy may be helpful for the treatment of aortic aneurysm.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.025 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.033 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".