■多部位疼痛患者是否有更高的心血管疾病风险尚不清楚。
■本研究的目的是探讨多部位疼痛与心肌梗死(MI)和卒中的纵向关联,并解开这些关联的遗传因果关系。
■总共有281,760名参与者(平均年龄:56.3岁)在英国生物银行研究的基线时没有MI和卒中。髋部疼痛的数据,膝盖,背部和颈部/肩部,或者“全身”都被收集起来了。如果疼痛持续≥3个月,则定义为慢性疼痛。从入院记录和死亡登记处确定MI和卒中事件。Cox回归和2个样本孟德尔随机化用于分析。
■在11.9年的中位随访期间,4,854患有第一次MI,2,827患有第一次中风。在多变量分析中,更多的疼痛部位与更高的MI和卒中事件风险相关,在“全身疼痛”的参与者中,风险较高(MI:HR:1.65,95%CI:1.32-2.07;卒中:HR:1.44,95%CI:1.13-1.85)。在慢性疼痛患者中观察到类似的趋势和关联。双样本孟德尔随机化结果支持多部位疼痛对MI风险的因果效应,但反之亦然。多部位疼痛与卒中风险之间没有因果关系。
■多个部位的疼痛会增加心梗的风险,强调在评估个体MI风险时应该考虑疼痛,疼痛治疗和管理可以预防MI风险。
UNASSIGNED: Whether individuals with multisite pain had a higher risk of cardiovascular diseases is unclear.
UNASSIGNED: The purpose of this study was to investigate the longitudinal association of pain in multiple sites with incident myocardial infarction (MI) and stroke, and to disentangle the genetic causality of these associations.
UNASSIGNED: A total of 281,760 participants (mean age: 56.3 years) who had no MI and stroke at baseline from UK Biobank study were included. Data on pain in the hip, knee, back and neck/shoulder, or \'all over the body\' were collected. Chronic pain was defined if pain had lasted for ≥3 months. MI and stroke events were determined from hospital admission records and death registries. Cox regression and 2-sample Mendelian randomization were used for the analyses.
UNASSIGNED: During a median follow-up of 11.9 years, 4,854 had a first MI and 2,827 had a first stroke. In multivariable analyses, greater number of painful sites was dose-responsively associated with higher risks of incident MI and stroke, with a higher risk among participants with pain \'all over the body\' (MI: HR: 1.65, 95% CI: 1.32-2.07; stroke: HR: 1.44, 95% CI: 1.13-1.85). Similar trends and associations were observed in those with chronic pain. Two-sample Mendelian randomization results supported a causal effect of multisite pain on MI risk, but not vice versa. No causal association was found between multisite pain and stroke risk.
UNASSIGNED: Pain in multiple sites causally increases the risk of MI, highlighting that pain should be considered when assessing individuals\' MI risk, and pain treatment and management may prevent MI risk.