Importance Although hidradenitis suppurativa (HS) is associated with several cardiovascular risk mediators, information on the risk of myocardial infarction (MI) and cerebrovascular accident (CVA) in this population is sparse.

Objective To compare risk of MI, CVA, and composite disease (MI or CVA) in patients with HS, stratified by use of biologic agents, with controls without HS.

Design, Setting, and Participants A retrospective cohort analysis was conducted between January 1, 1999, and April 1, 2019, using a demographically heterogeneous population-based sample of over 56 million unique patients. Individuals with HS (n = 49 862) and without HS (n = 1 421 223) were identified using electronic health records data.

Main Outcomes and Measures The primary outcome was incidence of composite MI or CVA.

Results Of the 49 862 patients with HS, 37 981 were women (76.2%), 29 711 were white (59.6%), and mean (SD) age was 38.3 (13.3) years. Crude incidence rate of composite disease was 6.6 (95% CI, 6.3-7.0) per 1000 person-years in patients with HS compared with 6.8 (95% CI, 6.7-6.8) per 1000 person-years in controls. In patients with HS, crude incidence rates were 2.9 (95% CI, 2.6-3.1) per 1000 person-years for MI alone and 4.1 (95% CI, 3.9-4.4) per 1000 person-years for CVA alone compared with 3.2 (95% CI, 3.18-3.25) per 1000 person-years for MI alone in control patients and 4.1 (95% CI, 4.0-4.1) per 1000 person-years for CVA alone in control patients. In adjusted analysis, patients with HS had a 23% increased risk of composite disease (hazard ratio [HR], 1.23; 95% CI, 1.17-1.30; P < .001) and a similar increase in the risk of MI alone (HR, 1.21; 95% CI, 1.12-1.32; P < .001) and CVA alone (HR, 1.22; 95% CI, 1.14-1.31; P < .001) compared with control patients. The relative difference in composite MI or CVA risk between patients with HS and controls was highest among younger patients HR in subgroup aged 18-29 years: 1.67; 95% CI, 1.37-2.03).

Conclusions and Relevance Patients with HS appear to have an increased risk of MI and CVA. Early management of modifiable cardiovascular risk mediators may be warranted in patients with HS.

重要性 尽管化脓性汗腺炎（HS）与几种心血管危险介质有关，但该人群中有关心肌梗塞（MI）和脑血管意外（CVA）风险的信息很少。

目的 比较采用生物制剂和无HS对照组的HS患者发生MI，CVA和复合疾病（MI或CVA）的风险。

设计，背景和参与者 回顾性队列分析是在1999年1月1日至2019年4月1日之间进行的，使用了基于人口统计学的异质人群样本，样本样本超过5600万。使用电子健康记录数据识别出患有HS（n = 49862）和没有HS（n = 1421223）的个体。

主要结果和措施 主要结果是复合性MI或CVA的发生率。

结果 49 862名HS患者中，女性37 981名（76.2％），白人29 711名（59.6％），平均（SD）年龄为38.3（13.3）岁。HS患者的复合疾病粗发病率是每千人年6.6（95％CI，6.3-7.0），而对照组每千人年6.8（95％CI，6.7-6.8）。在HS患者中，单纯心梗的发病率是每千人年2.9（95％CI，2.6-3.1），而单纯CVA的发病率是每1000人年4.1（95％CI，3.9-4.4），而同期CVA的发生率是3.2（在对照患者中，仅每1000人年的95％CI，每1000人年3.18-3.25），在单独CVA中，每1000人年的4.1（95％CI，4.0-4.1）每1000人年。在调整后的分析中，HS患者发生复合疾病的风险增加了23％（危险比[HR]为1.23； 95％CI为1.17-1.30；P <.001）和单独的MI（HR，1.21; 95％CI，1.12-1.32; P  <.001）和单独的CVA（HR，1.22; 95％CI，1.14-1.31; P  < .001）与对照组相比。在18-29岁亚组中，年轻的HR患者中，HS患者与对照组之间的复合MI或CVA风险的相对差异最大：1.67；95％CI，1.37-2.03）。

结论和相关性 HS患者似乎出现MI和CVA的风险增加。HS患者应尽早治疗可改变的心血管危险介质。