Autoimmune blistering disorders and cardiovascular risks: A population-based cohort study.

BACKGROUND: Autoimmune blistering disorders (ABDs) might elevate cardiovascular risk, but studies are lacking.

OBJECTIVE: To examine if ABDs elevate the risk of atherosclerotic cardiovascular disease (ASCVD), heart failure, arrhythmia, venous thromboembolism, and cardiovascular death.

METHODS: A population-based cohort of Danish patients with ABD (≥18 years of age) diagnosed during 1996-2021 (n=3,322) was compared with an age and sex-matched comparison cohort from the general population (n=33,195).

RESULTS: Compared with the general population, patients with ABDs had higher one-year risks of ASCVD (3.4% vs. 1.6%), heart failure (1.9% vs. 0.7%), arrhythmia (3.8% vs. 1.3%), venous thromboembolism (1.9% vs. 0.3%), and cardiovascular death (3.3% vs. 0.9%). The elevated risk persisted after 10 years for all outcomes but arrhythmia. The hazard ratios associating ABD with the outcomes during the entire follow-up were 1.24 (1.09-1.40) for ASCVD, 1.48 (1.24-1.77) for heart failure, 1.16 (1.02-1.32) for arrhythmia, 1.87 (1.50-2.34) for VTE, and 2.01 (1.76-2.29) for cardiovascular death. The elevated cardiovascular risk was observed for both pemphigus and pemphigoid.

LIMITATIONS: Our findings might only generalize to patients with ABDs without prevalent cardiovascular diseases.

CONCLUSION: Patients with ABDs had an elevated cardiovascular risk compared with age and sex-matched controls.