Acupuncture decreased the risk of coronary heart disease in patients with fibromyalgia in Taiwan: a nationwide matched cohort study

Abstract

Background: The aim of this study was to understand whether acupuncture can decrease the risk of coronary heart disease (CHD) in patients with fibromyalgia.

Methods: Using data from the Taiwanese National Health Insurance Research Database, we performed a propensity score-matched cohort study to analyze patients with fibromyalgia diagnosed between 1 January 2000 and 31 December 2010. Patients who received acupuncture treatment, beginning with their initial date of fibromyalgia diagnosis and extending to 31 December 2010, were regarded as the acupuncture cohort. The no-acupuncture cohort comprised patients who never received acupuncture through 31 December 2010. A Cox regression model was used to adjust for age, sex, comorbidities, and drugs used. The HRs of the acupuncture and no-acupuncture cohorts were compared.

Results: After performing a 1:1 propensity score match, 58,899 patients in both cohorts were identified. Baseline characteristics were similar in both cohorts. The cumulative incidence of CHD was significantly lower in the acupuncture cohort (log-rank test, p < 0.001). In the follow-up period, 4389 patients in the acupuncture cohort (17.44 per 1000 person-years) and 8133 patients in the no-acupuncture cohort (38.36 per 1000 person-years) developed CHD (adjusted HR 0.43, 95% CI 0.41-0.45). The beneficial effect of acupuncture on the incidence of CHD was independent of age, sex, comorbidities, and statins used.

Conclusions: Our study confirmed that acupuncture reduced the risk of CHD in patients with fibromyalgia in Taiwan. Further clinical and mechanistic studies are warranted.

Keywords: Acupuncture; Coronary heart disease; Fibromyalgia; National Health Insurance Research Database; Taiwan.

Fig. 1

Study population flowchart. After the exclusion process, we identified 158,425 patients with fibromyalgia newly diagnosed between 2000 and 2010. After matching 1:1 by sex, age, comorbidities, and drugs used, the acupuncture cohort and no-acupuncture cohorts each contained 58,899 patients. LHID 2000 Longitudinal Health Insurance Database 2000, NHI National Health Insurance

Fig. 2

Cumulative incidence of coronary heart disease (CHD) between the acupuncture cohort and the no-acupuncture cohort. The cumulative incidence of CHD in the acupuncture cohort (dashed line) is significantly lower than in the no-acupuncture cohort (solid line) (log-rank test, p < 0.001)