Pain Perception is Attenuated in Patients With Painless Myocardial Infarction

This study has been completed.
Sponsor:
Information provided by:
Rambam Health Care Campus
ClinicalTrials.gov Identifier:
NCT00192790
First received: September 12, 2005
Last updated: April 10, 2007
Last verified: April 2007
  Purpose

To explore whether reduced systemic pain perception in response to painful stimuli and personality pain related variables characterizes silent MI patients.


Condition
Myocardial Infarction
Myocardial Ischemia

Study Type: Observational
Study Design: Observational Model: Defined Population
Time Perspective: Longitudinal
Official Title: Clinical and Experimental Pain Perception is Attenuated in Patients With Painless Myocardial Infarction

Resource links provided by NLM:


Further study details as provided by Rambam Health Care Campus:

Estimated Enrollment: 100
Study Start Date: January 2004
Study Completion Date: March 2005
Detailed Description:

Objective: Silent myocardial infarction (MI) is an event of severe myocardial ischemia without pain experience. The lack of pain alarm leads to increased morbidity and mortality, because the patients do not sick timely medical treatment. This study aims to explore whether reduced systemic pain perception in response to painful stimuli and personality pain related variables characterizes silent MI patients.

Methods: Level of chest pain intensity was assessed by visual analogue scale (VAS), range from 0 (no pain) to 100 (maximal pain). Heat pain threshold, magnitude estimation of supra-threshold painful stimuli at 47ºC as well as pain catastrophizing scores were assessed in 90 acute MI patients (mean age 66±12.1, range 33-79) with chest pain (n=65) and without pain symptoms(n=25). All stimuli were performed by Thermal Sensory Analysis (TSA) and applied to the right forearm.

Results: The demographic variables, history of ischemic heart, risk factors for coronary artery disease, ST-T segment changes on ECG and troponin levels were similar in both groups. Greater intensity of chest pain VAS scores was inversely correlated with lower pain threshold (r= -0.417, p<0.001), and directly associated with higher pain scores in response to the heat pain (r=0.354, p=0.002). Patients with painful MI demonstrated lower pain threshold (41.9±3.6 vs. 44.9±3.8, p=0.001), higher VAS scores in response to the supra-threshold painful stimuli (50.2 ±21.8 vs. 27.0±25.2, p=0.002), and higher catastrophizing level (10.6±12.0 vs. 5.4±8.8, p=0.032). Chest pain complaint was not related to ST-T changes as well as concomitant diseases.

Conclusions: This study suggests that reduced systemic pain perception as well as cognitive personality variables play an important role in the etiology of Silent MI.

  Eligibility

Ages Eligible for Study:   18 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:All patients with painless or painful myocardial infarction -

Exclusion Criteria:Patients who can't give informed concent or couldn't cooperate

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  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00192790

Locations
Israel
RAMBAM Health Care Campus, Internal Medicine "B" & Cardiology
Haifa, Israel, 31096
Sponsors and Collaborators
Rambam Health Care Campus
Investigators
Principal Investigator: Zaher S. Azzam, MD Rambam Medical Center, The Ruth & Bruce Rappaport Faculty of Medicine Technion
  More Information

No publications provided by Rambam Health Care Campus

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
ClinicalTrials.gov Identifier: NCT00192790     History of Changes
Other Study ID Numbers: ZSA1871CTIL, ------
Study First Received: September 12, 2005
Last Updated: April 10, 2007
Health Authority: Israel: Israeli Health Ministry Pharmaceutical Administration

Keywords provided by Rambam Health Care Campus:
Therma,pain, Silent myocardial ischemia, catastrophizing

Additional relevant MeSH terms:
Myocardial Ischemia
Coronary Artery Disease
Infarction
Ischemia
Myocardial Infarction
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Coronary Disease
Arteriosclerosis
Arterial Occlusive Diseases
Pathologic Processes
Necrosis

ClinicalTrials.gov processed this record on July 23, 2014