Presentation: Association of Fibromyalgia with Coronary Angiography (2007)

1533 Association of Fibromyalgia with Coronary Angiography

Fibromyalgia (FM) has been associated with physical and emotional trauma including invasive medical procedures. A clinical, epidemiological and pathogenetic association links fibromyalgia and depression. Ischemic heart disease and congestive heart failure have also been linked with depression, which negatively affects outcome. Ongoing chest pain is common among patients with non significant coronary artery disease who suffer a high frequency of rheumatological disorders including FM.
Aim:
To study the frequency of FM symptoms and physical findings, such as pain, tenderness and depression, among patients undergoing coronary catheterization; to evaluate the occurrence of FM symptoms initiated by invasive coronary procedures, and to examine the possibility of FM acting as a risk factor for undergoing a normal - coronary ("unnecessary") coronary angiography.
Methods:
Patients who underwent coronary angiography during the previous 12 months were recruited. Demographic data as well and results of coronary angiography and interventions were documented. Patients completed the fibromyalgia impact questionnaire (FIQ) and underwent dolorimetry for tender point assessment. Depression was assessed according to response to the FIQ depression subscale (FIQ-D). Patients were analyzed in three groups: A- normal coronary arteries (50 patients) B- significant coronary pathology and intra coronary procedures (43 patients) and C - healthy volunteers (51 individuals).
Statistics: Fisher's exact test was used for unidirectional analysis of variance and a p<0.05 was considered significant. Multivariate linear regression was performed to control for age, gender, use of medications etc.
Results:
Significantly increased levels of tenderness were observed in group B compared with groups A and C (p=0.0005). Patients in group B ranked significantly higher on the FIQ scale compared to patients in group A, who ranked significantly higher than group C (p<0.0001). Significantly increased levels of depression were found in group B compared to group A, who had significantly higher levels than group C (p<0.001).
ON multivariate regression analysis, patients with coronary pathology had significantly higher levels of tenderness (p=0.019, R=0.46) and significantly higher scores on the FIQ (p=0.005, R= 0.354) than patients with normal coronary arteries or healthy controls.
Conclusion:Coronary angiography is associated with a significant increase in the frequency of pain, tenderness and depression in the 12 months following the procedure. These results are particularly significant in patients undergoing invasive intra - coronary procedures. This association may impact on the outcome of patients with coronary disease and affect the quality of life and health care utilization of this patient population

 J.N. Ablin, None; N. Beilinson, None; V. Aloush, None; O. Elkayam, None; A. Finkelstein, None.