Cardiovascular associations with onychomycosis: A global trinetx database analysis

Summary: Abstract Body: Onychomycosis is the most common nail condition seen in clinical practice. There are reported associations between onychomycosis and both diabetes and obesity, which are risk factors for cardiovascular conditions. Thus, we hypothesized that there could be an association between onychomycosis and cardiovascular disease and studied these relationships using a large multicenter database. The TrinetX research database was utilized on 1/13/2025 to search for patients ≥ 18 years of age with onychomycosis (ICD 10: B35.1). All patients were propensity-score matched to controls without onychomycosis based on sex, current age, race, ethnicity, diabetes, smoking history, obesity and metabolic syndrome. The odds of developing cardiovascular disease risk ≥1 day following diagnosis of onychomycosis was examined. 537,716 onychomycosis patients and 537,716 propensity-matched controls were included. Cohorts were well matched with a mean age of onychomycosis and control patients of 66.3 and 66.3-years (p=0.8445), and majority male (46.1% and 46.1%, p=0.9306) and White (58.9% and 58.9%, p=0.885), respectively. Patients with vs. without onychomycosis had increased odds of peripheral vascular disease (OR=3.10, 95%CI 3.06-3.14), venous insufficiency (2.76, 2.71-2.81), cardiac arrest (1.45, 1.39-1.51), cerebral infarction (1.43, 1.41-1.45), cardiomyopathy (1.32, 1.29-1.34), cardiac arrhythmias (1.28, 1.27-1.30), acute myocardial infarction (1.24, 1.21-1.26), angina pectoralis (1.23, 1.20-1.25), atherosclerosis (1.19, 1.18-1.20), and chronic ischemic heart disease (1.19, 1.18-1.20). Our study found that onychomycosis was associated with higher odds of cardiovascular comorbidities, suggesting that onychomycosis may be a warning sign for cardiovascular disease. Dev Patel¹, Naeha Pathak¹, Omar Alani¹, Amit Singal², Shari Lipner³ 1. Icahn School of Medicine at Mount Sinai, New York, NY, United States. 2. Rutgers New Jersey Medical School, Newark, NJ, United States. 3. Weill Cornell Medicine, New York, NY, United States. Clinical Research: Epidemiology and Observational Research