Alopecia Patients May Be at Increased Risk of Heart Attack

By David Douglas

May 22, 2020

NEW YORK (Reuters Health) - Patients with alopecia areata (AA) appear to be at heightened risk of acute myocardial infarction (AMI), according to a large population-based study from South Korea.

"Our findings possibly imply that AA is not an autoimmune disease limited to skin but has a systemic impact. Patients with AA increased their risk of developing AMI over time despite having better cardiovascular risk profiles," Dr. Jung-Won Shin of Seoul National University Bundang Hospital, in Seongnam, told Reuters Health by email.

Several studies have suggested that AA may be related to chronic immune-mediated inflammatory diseases that are known to be associated with cardiovascular disease, she and her colleagues note in JAMA Dermatology.

The researchers examined national insurance and screening data and identified more than 228,000 patients aged 30 to 89 years who were diagnosed with AA between 2006 and 2017. They were compared with more than 4.5 million matched controls.

With the exception of smoking, patients with AA tended to have "slightly better" cardiovascular risk profiles than controls and had a lower cumulative AMI incidence in the medium term (two to four years).

However, there was an exponential increase in risk among AA patients as time went on, and the adjusted hazard ratio became statistically significant by eight to 10 years of the 12-year follow-up period. In the last two-year period (10 to 12 years), the aHR was 4.51 (95% confidence interval, 3.65 to 5.58) overall.

The pattern was similar regardless of whether patients smoked, but the risk was even more increased for those who did. The same was true of men and people younger than 50 years of age.

Dr. Shin concluded that "close, long-term monitoring of cardiovascular health and education, such as anti-smoking measures, appears necessary for patients with AA."

Dermatologist Dr. Lindsey A. Bordone of ColumbiaDoctors, in New York City, who specializes in hair disorders, told Reuters Health by email that "this is a very interesting paper and new analysis done on health data (that) may lead us down a similar path to the one we are now on with other auto-inflammatory conditions such as psoriasis."

"I think papers highlighting further research into the link between alopecia areata and other chronic illnesses will start to come out in the years ahead," added Dr. Bordone, who was not involved in the study.

SOURCE: https://bit.ly/2ZnpIVl JAMA Dermatology, online May 13, 2020.

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