Risk of Venous Thromboembolism among Adults with Atopic Dermatitis

Tai Li Chen, Wan Ting Huang, Ching Hui Loh, Huei Kai Huang*, Ching Chi Chi*

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

9 引文 斯高帕斯(Scopus)

摘要

Importance: The associations of atopic dermatitis (AD) with multiple cardiovascular comorbidities have been investigated because of its pathomechanisms regarding chronic systemic inflammation and potential vascular effects. Nevertheless, the association between AD and incident venous thromboembolism (VTE) in adulthood is largely unknown. This study aimed to investigate the association of AD with incident VTE. Objective: To examine the risk of incident VTE among patients with AD. Design, Setting, and Participants: This population-based nationwide cohort study included adults 20 years or older (adults with AD newly diagnosed between 2003 and 2017 and matched controls) from the National Health Insurance Research Database. Patients with AD were subgrouped according to the severity of the disease. A Cox regression model was used to estimate hazard ratios (HRs) for VTE. Stratified analyses according to age and sex, and a sensitivity analysis excluding systemic steroid users were performed. Main Outcomes and Measures: Hazard ratios (HRs) for incident VTE associated with AD. Results: This analysis included a total of 284858 participants, with 142429 participants each in the AD (mean [SD] age, 44.9 [18.3] years; 78213 women) and non-AD cohorts (mean [SD] age, 44.1 [18.1] years; 79636 women). During the follow-up, 1066 patients (0.7%) in the AD cohort and 829 patients (0.6%) in the non-AD cohort developed VTE, with incidence rates of 1.05 and 0.82 per 1000 person-years, respectively. Adults with AD had a significantly increased risk of incident VTE (HR, 1.28; 95% CI, 1.17-1.40) compared with adults without AD. Individual outcome analyses suggested that AD was associated with higher risks of deep vein thrombosis (HR, 1.26; 95% CI, 1.14-1.40) and pulmonary embolism (HR, 1.30; 95% CI, 1.08-1.57). Conclusions and Relevance: The results of this cohort study suggest that AD in adulthood is associated with an increased risk of VTE; however, the absolute risk difference of VTE between adults with and without AD appears small. Nevertheless, cardiovascular examination and imperative management may be considered for adults with AD who present with symptoms suggestive of VTE. Future research is warranted to elucidate the pathophysiology underlying the association between AD and VTE.

原文英語
頁(從 - 到)720-727
頁數8
期刊JAMA Dermatology
159
發行號7
DOIs
出版狀態已出版 - 01 07 2023

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© 2023 American Medical Association. All rights reserved.

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