US researchers have identified an elevated risk of myocardial infarction (MI) among patients with psoriasis, particularly in young individuals with severe psoriatic symptoms.

"The results add to the growing evidence linking T-helper-1 diseases to atherosclerosis and coronary artery disease," the team writes in the Journal of the American Medical Association.

Using the UK General Practice Research Database, the investigators from the University of Pennsylvania in Philadelphia, led by Joel Gelfand, identified 127,139 patients with mild psoriasis and 3837 with severe psoriasis, defined by the need for systemic medication.

Among patients with mild and severe psoriasis, the incidence of MI was 4.04 and 5.13 per 1000 person-years, respectively. In contrast, the MI rate among 556,995 randomly selected control individuals was 3.58 per 1000 person-years.

The high MI incidence among patients with severe psoriasis is "consistent with the hypothesis that greater immune activity in psoriasis is related to a higher risk of MI", the researchers note.

A strong association was also found between MI and the age of the psoriatic patients, with young individuals having the highest risk of MI.

For example, the relative risk (RR) for MI was around 4.0 among 20-year-olds with severe psoriasis, falling to 1.4 among 60-year-olds with severe symptoms. The corresponding RRs for patients with mild psoriasis were about 1.3 and 1.0.

"Our findings are novel and therefore it is important that additional studies be performed to confirm these results and determine their therapeutic implications," the authors conclude.

"In the meantime, as part of good medical care, patients with psoriasis should be encouraged to aggressively address their modifiable cardiovascular risk factors."

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