BACKGROUND: Patients with psoriasis may have increased risk of major adverse cardiovascular (CV) events (MACE), and a family history of CV disease (CVD) is an independent risk factor for MACE.

OBJECTIVE: We investigated the risk of first-time MACE in patients with psoriasis with or without a family history of CVD.

METHODS: Between January 1, 1997, and December 31, 2011, we identified 2,722,375 individuals, including 25,774 and 4504 patients with mild and severe psoriasis, through administrative registers. Incidence rate ratios were estimated by Poisson regression.

RESULTS: Mean baseline age was 26.6 (SD 8.6) years. A family history of CVD was found among 16,080 (62.4%) and 3009 (66.8%) patients with mild and severe psoriasis, respectively. In patients with psoriasis and a family history of CVD, the adjusted incidence rate ratios (95% CI) of MACE were 1.28 (1.12-1.46) and 1.62 (1.14-2.30) for mild and severe disease, respectively. In patients with psoriasis but without a family history of CVD, there was no increased risk of MACE.

LIMITATIONS: Results may not apply to late-onset psoriasis.

CONCLUSIONS: A family history of CVD predicted the risk of first-time MACE in young adults with psoriasis. The findings call for increased focus on a family history of CVD in CV risk assessment of patients with psoriasis.