Psoriasis and atrial fibrillation: Exploring the intersection

Abstract

This review explores the emerging connection between psoriasis and atrial fibrillation (AF), focusing on shared inflammatory mechanisms, clinical implications, and research gaps. Psoriasis, characterized by chronic systemic inflammation, has been associated with increased AF risk, driven by elevated pro-inflammatory cytokines such as interleukin (IL)-6, IL-17, and tumor necrosis factor-alpha. These inflammatory mediators contribute to atrial remodeling, fibrosis, and conduction abnormalities, evidenced by prolonged P-wave dispersion and atrial electromechanical delay in psoriasis patients. Severe psoriasis further exacerbates atrial dysfunction, increasing susceptibility to AF. This review synthesizes existing epidemiological and biological data, highlighting the need for interdisciplinary management of psoriasis patients to mitigate cardiovascular risks. However, the reliance on observational studies limits definitive conclusions about causality. We emphasize the necessity for large-scale, multicenter research to validate these findings, investigate genetic predispositions, and evaluate lifestyle factors and AF burden. Future research should aim to delineate the pathophysiological link between psoriasis and AF. By examining the interplay of systemic inflammation, electrophysiological changes, and clinical outcomes, this review aims to advance understanding of the psoriasis-AF link and guide strategies for early detection, prevention, and management of AF in psoriasis patients. Comprehensive care integrating dermatology and cardiology is essential for improving patient outcomes.

Keywords: Psoriasis; Atrial fibrillation; Inflammation; Cytokines; Cardiovascular disease; Biologic therapies

Core Tip: Emerging evidence indicates an intricate link between psoriasis and atrial fibrillation (AF) with a heightened risk of AF amongst psoriatic patients compared to general population. Although the exact mechanisms remain elusive, the role of chronic systemic inflammation is central to the pathogenesis of AF in psoriasis. By examining the interplay of systemic inflammation, electrophysiological changes, and clinical outcomes, this review aims to advance understanding of the psoriasis-AF link and guide strategies for early detection, prevention, and management of AF in psoriasis patients.