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Low pain tolerance is associated with coronary angiography, coronary artery disease, and mortality: The TROMSO study

Permanent lenke
https://hdl.handle.net/10037/23863
DOI
https://doi.org/10.1161/JAHA.121.021291
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article.pdf (766.5Kb)
Publisert versjon (PDF)
Dato
2021-11-03
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Forfatter
Fladseth, Kristina; Lindekleiv, Haakon; Nielsen, Christopher Sivert; Øhrn, Andrea; Kristensen, Andreas; Mannsverk, Jan Torbjørn; Løchen, Maja-Lisa; Njølstad, Inger; Wilsgaard, Tom; Mathiesen, Ellisiv B.; Stubhaug, Audun; Trovik, Thor; Rotevatn, Svein; Forsdahl, Signe Helene; Schirmer, Henrik
Sammendrag
BACKGROUND: The initial presentation to coronary angiography and extent of coronary artery disease (CAD) vary greatly among patients, from ischemia with no obstructive CAD to myocardial infarction with 3-vessel disease. Pain tolerance has been suggested as a potential mechanism for the variation in presentation of CAD. We aimed to investigate the association between pain tolerance, coronary angiography, CAD, and death.

METHODS AND RESULTS: We identified 9576 participants in the Tromsø Study (2007–2008) who completed the cold-pressor pain test, and had no prior history of CAD. The median follow-up time was 10.4 years. We applied Cox-regression models with age as time-scale to calculate hazard ratios (HR). More women than men aborted the cold pressor test (39% versus 23%). Participants with low pain tolerance had 19% increased risk of coronary angiography (HR, 1.19 [95% CI, 1.03–1.38]) and 22% increased risk of obstructive CAD (HR, 1.22 [95% CI, 1.01–1.47]) adjusted by age as time-scale and sex. Among women who underwent coronary angiography, low pain tolerance was associated with 54% increased risk of obstructive CAD (HR, 1.54 [95% CI, 1.09–2.18]) compared with high pain tolerance. There was no association between pain tolerance and nonobstructive CAD or clinical presentation to coronary angiography (ie, stable angina, unstable angina, and myocardial infarction). Participants with low pain tolerance had increased risk of mortality after adjustment for CAD and cardiovascular risk factors (HR, 1.40 [95% CI, 1.19–1.64]).

CONCLUSIONS: Low cold pressor pain tolerance is associated with a higher risk of coronary angiography and death.

Er en del av
Fladseth, K. (2022). Clinical characteristics, mortality and pain tolerance in stable versus acute presentation of coronary heart disease. (Doctoral thesis). https://hdl.handle.net/10037/26711.
Forlag
American Heart Association
Sitering
Fladseth, Lindekleiv, Nielsen, Øhrn ASHM, Kristensen, Mannsverk, Løchen M, Njølstad, Wilsgaard, Mathiesen, Stubhaug, Trovik, Rotevatn, Forsdahl, Schirmer. Low pain tolerance is associated with coronary angiography, coronary artery disease, and mortality: The TROMSO study. Journal of the American Heart Association (JAHA). 2021;10(22)
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  • Artikler, rapporter og annet (psykologi) [564]
Copyright 2021 The Author(s)

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