Background/Purpose: Psoriasis, a chronic inflammatory skin condition, is increasingly linked to systemic cardiovascular risks. Atrial fibrillation (AF), the most common cardiac arrhythmia, is associated with elevated risks of stroke, heart failure, and mortality. This study evaluates the association between psoriasis and AF.

Methods: This meta-analysis evaluated the association between Psoriasis and Atrial Fibrillation by systematically reviewing observational studies published through December 2024. Study selection followed PRISMA guidelines, extracting data on patient characteristics and adjusted risk estimates.

Results: Eight studies comprising 11,579,730 participants (277,597 with psoriasis and 11,302,133 controls) were included. Psoriasis was associated with a significantly higher risk of AF (HR: 1.27; 95% CI: 1.17–1.38). Subgroup analyses revealed that severe psoriasis was associated with a higher risk of AF (HR: 1.32; p < 0.05) as compared to mild psoriasis (HR: 1.22; p < 0.05), but the difference was not statistically significant (p = 0.41). Age-stratified analysis showed an elevated risk in individuals aged ≥45 years (HR: 1.40; p < 0.05) compared to those < 45 years (HR: 1.21; p < 0.05). Regional analysis demonstrated comparable risks in Asia (HR: 1.27; p < 0.05) and non-Asia (HR: 1.28; p < 0.05), with no significant subgroup differences (p = 0.93). Publication bias was not evident based on visual inspection of the funnel plot and Egger’s regression test (p = 0.24).

Conclusion: This analysis of observational studies shows an association between psoriasis and increased risk of AF risk. Subgroup analysis shows that risk of AF is higher in severe psoriasis and older patients. Future large studies are needed to clarify underlying mechanisms, and assess the potential role of AF screening in improving outcomes for this high-risk population.

Forest Plot Showing the Association Between Risk of Atrial Fibrillation in Psoriasis 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-risk-of-atrial-fibrillation-in-patients-with-psoriasis-a-systematic-review-and-meta-analysis/