Association between pain and incident arrhythmias in 422,654 individuals: evidence from the UK Biobank cohort.

IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Pei Qin, Barbara I Nicholl, Frederick K Ho, Peter Hanlon, Carlos A Celis-Morales, Jill P Pell
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引用次数: 0

Abstract

Aims: Pain is associated with cardiovascular disease; however, its association with incident arrhythmias is unclear. We assessed associations between different pain characteristics (pain type, chronic pain, chronic widespread pain [chronic widespread pain], chronic musculoskeletal pain [chronic musculoskeletal pain], and number of chronic pain and chronic musculoskeletal pain sites) and incident cardiac arrhythmias, overall and by subtype.

Methods: The study included 422,654 UK Biobank participants. Pain was ascertained via a touchscreen questionnaire. The outcomes were incident arrhythmias: all cardiac arrhythmias, atrial fibrillation (AF), other (non-AF) cardiac arrhythmias, bradyarrhythmias, and ventricular arrhythmias. Multivariable Cox-proportional regression was used to investigate the associations.

Results: Over a mean (SD) follow-up of 13.19 (1.96) years, 36,860 (8.72%) participants developed arrhythmia. Compared with those without pain, those with chronic localized pain and chronic widespread pain had increased risk of all cardiac arrhythmias (hazard ratio [HR] 1.13, 95% confidence interval [CI], 1.10-1.17; 1.34, 1.19-1.51), AF (1.09, 1.05-1.14; 1.33, 1.15-1.55), and other cardiac arrhythmias (1.17, 1.12-1.22; 1.41, 1.20-1.66). There was evidence of a dose-relationship between number of chronic pain sites and risk of all cardiac arrhythmias, AF and bradyarrhythmias. Effect estimates were significantly larger among participants aged <60 years than those aged ≥60 years, and larger in women than men.

Conclusions: Chronic pain was associated with cardiac arrhythmias. Whilst causation cannot be assumed in any observational study, there was evidence of both a temporal relationship and dose-relationship. These findings reinforce the need for pain management approaches that include a broad assessment of individuals' risk factors, wider health status, and appropriate vigilance for emerging conditions.

422,654例个体疼痛与突发心律失常之间的关系:来自英国生物银行队列的证据
目的:疼痛与心血管疾病相关;然而,其与心律失常的关系尚不清楚。我们评估了不同疼痛特征(疼痛类型、慢性疼痛、慢性广泛性疼痛、慢性肌肉骨骼疼痛、慢性疼痛和慢性肌肉骨骼疼痛部位的数量)与心律失常发生率之间的相关性,包括总体和亚型。方法:该研究包括422,654名英国生物银行参与者。疼痛是通过触屏问卷确定的。结果为偶发性心律失常:所有心律失常、心房颤动(AF)、其他(非AF)心律失常、慢速心律失常和室性心律失常。采用多变量cox -比例回归分析其相关性。结果:在平均(SD) 13.19(1.96)年的随访中,36,860(8.72%)名参与者出现心律失常。与无疼痛的患者相比,慢性局部性疼痛和慢性广泛性疼痛患者发生所有心律不整的风险增加(风险比[HR] 1.13, 95%可信区间[CI], 1.10-1.17;1.34, 1.19-1.51), af (1.09, 1.05-1.14;1.33, 1.15-1.55)和其他心律失常(1.17,1.12-1.22;1.41, 1.20 - -1.66)。有证据表明,慢性疼痛部位的数量与所有心律失常、房颤和慢速心律失常的风险之间存在剂量关系。结论:慢性疼痛与心律失常有关。虽然在任何观察性研究中都不能假定因果关系,但有证据表明两者存在时间关系和剂量关系。这些发现加强了对疼痛管理方法的需求,包括对个人风险因素的广泛评估,更广泛的健康状况,以及对新出现的疾病的适当警惕。
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来源期刊
European journal of preventive cardiology
European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
12.50
自引率
12.00%
发文量
601
审稿时长
3-8 weeks
期刊介绍: European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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