Association between fibromyalgia and coronary heart disease and coronary catheterization.
BACKGROUND
Fibromyalgia (FM) has been associated with physical and emotional trauma including invasive medical procedures. Both FM and ischemic heart disease have been linked with depression. The purpose of this study was to retrospectively investigate the frequency of FM symptoms and physical findings among patients undergoing coronary catheterization.


METHODS
Consecutive patients who underwent coronary angiography during the previous 6 mo were recruited. Patients with major depression, bi-polar disorder, schizophrenia, or malignancy were excluded. Patients underwent dolorimetry for tender-point assessment and completed the fibromyalgia impact questionnaire (FIQ). Group A included patients with significant coronary pathology (n = 43), group B included patients with normal coronary arteries (n = 50), and group C included patients with normal controls (n = 51). A cardiological score incorporated the number of coronary arteries with significant pathology and left ventricular function. Chi-square or Fisher's exact test was used for categorical data and a one-way analysis of variance for continuous variables; a multivariate linear regression was performed to compare groups.


RESULTS
Significantly increased levels of tenderness were discovered among patients with coronary pathology compared with healthy controls. Significantly increased levels of depression were also found, as well as higher scores on the FIQ scale. On multivariate analysis, a positive correlation was demonstrated between tenderness/FIQ scores and a composite cardiological score.


CONCLUSIONS
Coronary angiography is associated with a significantly increased frequency of pain, tenderness, and depression after 6 mo, apparent in both patients undergoing coronary procedures and patients with normal coronaries. This association may impact the outcome of patients with significant coronary disease.
Ablin
Jacob N
JN
Department of Internal Medicine 6, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ajacob@post.tau.ac.il
Beilinson
Natella
N
Aloush
Valerie
V
Elkayam
Ori
O
Finkelstein
Ariel
A
D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000523:psychology; D017023:Coronary Angiography / Q000009:adverse effects* / Q000523:psychology; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology; D003863:Depression / Q000209:etiology; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D016277:Ventricular Function, Left