Cardiovascular risk in patients with alopecia areata (AA): A propensity-matched retrospective analysis

J Am Acad Dermatol. 2016 Jul;75(1):151-4. doi: 10.1016/j.jaad.2016.02.1234. Epub 2016 May 13.

Abstract

Background: The cardiovascular risk of patients with alopecia areata (AA) is not well characterized, with limited studies evaluating the risk of acute myocardial infarction (AMI) and ischemic stroke.

Objective: We sought to determine the risk for patients with AA to develop subsequent stroke and AMI.

Methods: We conducted propensity-matched retrospective analysis between January 1, 2000, and January 1, 2010, from Brigham and Women's Hospital and Massachusetts General Hospital in Boston, MA. A comprehensive research patient data repository search was done for International Classification of Diseases, Ninth Revision code 704.01 and cases were verified using a natural language processing program. Propensity score matching was used to identify controls for AA cases based on age, race, gender, smoking status, and history of hypertension, diabetes, and hyperlipidemia.

Results: We identified 1377 cases of AA matched with 4131 controls. Patients with AA had decreased odds for developing stroke (odds ratio 0.39, 95% CI 0.18-0.87) and a trend toward decreased risk of AMI (odds ratio 0.91, 95% CI 0.59-1.39).

Limitations: This was a retrospective study using a clinical database.

Conclusion: Patients with AA had decreased risk for stroke and AMI, although not statistically significant. Further studies are needed to confirm these findings in other AA cohorts and to elucidate a potential mechanism.

Keywords: alopecia; alopecia areata; cardiovascular risk; metabolic risk; myocardial infarction; stroke.

MeSH terms

  • Adult
  • Alopecia Areata / complications
  • Alopecia Areata / epidemiology*
  • Boston / epidemiology
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Odds Ratio
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology