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Fibromyalgia is associated with coronary heart disease: a population-based cohort study
Pei-Shan Tsai1, Yen-Chun Fan, Chun-Jen Huang
1From the *Graduate Institute of Nursing, College of Nursing, Taipei Medical University; †Sleep Science Center, Taipei Medical University Hospital; and ‡Department of Anesthesiology, Taipei Tzu Chi Hospital, Taipei; §School of Medicine, Tzu Chi University, Hualien; and ∥School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Insights
Patients with fibromyalgia have a significantly increased risk of coronary heart disease (CHD). This study suggests a strong association between fibromyalgia and adverse coronary events, highlighting a critical need for cardiovascular monitoring in these patients.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Epidemiology
Background:
- Fibromyalgia is a chronic condition characterized by widespread pain.
- The relationship between fibromyalgia and cardiovascular disease risk is not well understood.
- Previous studies have suggested potential links, but robust evidence is lacking.
Purpose of the Study:
- To investigate the risk of coronary heart disease (CHD) in patients diagnosed with fibromyalgia.
- To compare CHD event rates between fibromyalgia patients and matched controls.
- To determine if fibromyalgia diagnosis is associated with an increased risk of adverse coronary events.
Main Methods:
- A matched-cohort study design was employed using Taiwan's National Health Insurance database.
- Data from 1 million enrollees were analyzed, focusing on patients with a fibromyalgia diagnosis.
- Propensity score and Cox proportional-hazards regression models were used to adjust for confounding factors.
Main Results:
- Patients with fibromyalgia demonstrated a significantly higher risk of experiencing a CHD event.
- The adjusted hazard ratio for CHD events in fibromyalgia patients was 2.11 (95% CI, 1.46-3.05).
- The association remained statistically significant after adjusting for baseline prognostic factors.
Conclusions:
- A significant association exists between fibromyalgia and an increased risk of coronary heart disease.
- Fibromyalgia patients may be at a substantially higher risk for adverse coronary events.
- Further research is warranted to explore the underlying mechanisms and clinical implications.
Background And Objectives:
We examined whether patients with a diagnosis of fibromyalgia have an increased risk of coronary heart disease (CHD), compared with age- and sex-matched control patients. We hypothesized that patients diagnosed with fibromyalgia are at increased risk of adverse coronary events.
Methods:
Using a matched-cohort study design, we analyzed data retrieved from the Longitudinal Health Insurance Database 2000 released by the National Health Research Institute, Taiwan. The Longitudinal Health Insurance Database 2000 includes medical claims data and registration files for 1 million enrollees randomly selected from the 2000 Registry for Beneficiaries (n = 23.72 million) of the National Health Insurance program. Patients treated for fibromyalgia at least once a month for 3 consecutive months following their initial diagnosis were enrolled in our study. The primary end point was the composite of CHD events, including percutaneous coronary interventions and coronary artery bypass grafting procedures. A propensity score was estimated by a logistic regression method, in which the fibromyalgia status was regressed on baseline prognostic factors. The hazard ratios and the 95% confidence intervals were estimated using multivariate Cox proportional-hazards regression models while adjusting for the propensity score.
Results:
After adjusting for the propensity score, the patients with fibromyalgia showed a significantly higher subsequent risk of a CHD event (hazard ratio, 2.11; 95% confidence interval, 1.46-3.05; P < 0.001) than the patients without fibromyalgia.
Conclusions:
An association between fibromyalgia and CHD appears to exist.
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