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Fibromyalgia Is Associated With Coronary Heart Disease: A Population-Based Cohort Study
  1. Pei-Shan Tsai, PhD*,,
  2. Yen-Chun Fan, MS and
  3. Chun-Jen Huang, MD, PhD,§
  1. *Graduate Institute of Nursing, College of Nursing, Taipei Medical University
  2. Sleep Science Center, Taipei Medical University Hospital
  3. Department of Anesthesiology, Taipei Tzu Chi Hospital, Taipei
  4. §School of Medicine, Tzu Chi University, Hualien
  5. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  1. Address correspondence to: Chun-Jen Huang, MD, PhD, Department of Anesthesiology, Taipei Tzu Chi Hospital, 289 Jianguo Rd, Sindian District, New Taipei City, 231, Taiwan (e-mail: huangcj1112{at}


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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  • This study was supported by a grant from National Science Council, Taiwan (NSC 102-2314-B-303-005-MY3) awarded to C.-J.H. and mainly conducted in Graduate Institute of Nursing, College of Nursing, Taipei Medical University, and Department of Anesthesiology, Taipei Tzu Chi Hospital.

    This study was presented in part at the Annual Meeting of the American Society of Anesthesiologists, San Francisco, California, October 12–16, 2013.

    The authors declare no conflict of interest.

    This study used data from the National Health Insurance Research Database that was provided by the National Health Research Institute (NHRI) and the Bureau of National Health Insurance (BNHI), Department of Health, Taiwan (registration no. 99121). The findings presented herein do not represent the views of the BNHI or the NHRI.