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Opium decreases the age at myocardial infarction and sudden cardiac death: a long- and short-term outcome evaluation.
Arch Iran Med. 2013 Mar; 16(3):154-60.AI

Abstract

BACKGROUND

Opium dependence is a recognized individual and public health threat, but little is known about its association with acute myocardial infarction (AMI) or sudden cardiac death (SCD).

METHODS

In a cross-sectional study followed by a one-year matched longitudinal cohort, all 569 men hospitalized with AMI in all Cardiac Care Units (CCU) of Isfahan, Iran, were recruited in a six-month period. In addition, 123 out-of-hospital deaths were included that were diagnosed as SCD at the same duration. Among those discharged alive, 126 opium dependents were matched with 126 nondependents (mostly nonusers) according to age and smoking status, and were followed for one year. Opium dependence was measured using the ICD10 criteria and Severity of Dependence Scale (SDS) questionnaire. The method was validated by morphine blood levels. Biochemical measurements, blood pressure, blood cell counts, anthropometrics, and ejection fraction were measured at baseline and repeated at the end of follow-up.

RESULTS

There were 118 (17.1%) patients with an average of 17.4 ± 10.4 years of abuse who met the criteria for opium dependency. Opium dependence decreased the age at event by 3.6 (95% CI: 1.2 - 6.0) years and was independent of smoking (P = 0.003). In terms of cardiovascular risk factors such as ejection fraction, in addition to post-AMI mortality and morbidity, no significant associations were noted at baseline or after one year of follow-up. The odds ratio of sustained smoking after AMI was 1.92 (95% CI: 1.04 - 3.52) in opium dependents (P = 0.033).

CONCLUSION

Despite public opinion, opium did not improve cardiovascular risk factors, or post-AMI mortality and morbidity. Conversely, there were irrefutable findings regarding the detrimental effects of opium dependence.

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Authors+Show Affiliations

Roohafza H
Mental Health Department, Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. talaei@crc.mui.ac.ir.
Talaei M
No affiliation info available
Sadeghi M
No affiliation info available
Haghani P
No affiliation info available
Shokouh P
No affiliation info available
Sarrafzadegan N
No affiliation info available

MeSH

AdultAge FactorsAgedAged, 80 and overCross-Sectional StudiesDeath, Sudden, CardiacFollow-Up StudiesHumansIranLinear ModelsMaleMiddle AgedMyocardial InfarctionNarcoticsOpioid-Related DisordersOpiumOut-of-Hospital Cardiac ArrestPrevalenceProportional Hazards ModelsRisk FactorsSeverity of Illness IndexSurveys and Questionnaires

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23432167

Citation

Roohafza, Hamidreza, et al. "Opium Decreases the Age at Myocardial Infarction and Sudden Cardiac Death: a Long- and Short-term Outcome Evaluation." Archives of Iranian Medicine, vol. 16, no. 3, 2013, pp. 154-60.
Roohafza H, Talaei M, Sadeghi M, et al. Opium decreases the age at myocardial infarction and sudden cardiac death: a long- and short-term outcome evaluation. Arch Iran Med. 2013;16(3):154-60.
Roohafza, H., Talaei, M., Sadeghi, M., Haghani, P., Shokouh, P., & Sarrafzadegan, N. (2013). Opium decreases the age at myocardial infarction and sudden cardiac death: a long- and short-term outcome evaluation. Archives of Iranian Medicine, 16(3), 154-60. https://doi.org/013163/AIM.007
Roohafza H, et al. Opium Decreases the Age at Myocardial Infarction and Sudden Cardiac Death: a Long- and Short-term Outcome Evaluation. Arch Iran Med. 2013;16(3):154-60. PubMed PMID: 23432167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opium decreases the age at myocardial infarction and sudden cardiac death: a long- and short-term outcome evaluation. AU - Roohafza,Hamidreza, AU - Talaei,Mohammad, AU - Sadeghi,Masoumeh, AU - Haghani,Poone, AU - Shokouh,Pedram, AU - Sarrafzadegan,Nizal, PY - 2013/2/26/entrez PY - 2013/2/26/pubmed PY - 2013/8/10/medline SP - 154 EP - 60 JF - Archives of Iranian medicine JO - Arch Iran Med VL - 16 IS - 3 N2 - UNLABELLED: BACKGROUND: Opium dependence is a recognized individual and public health threat, but little is known about its association with acute myocardial infarction (AMI) or sudden cardiac death (SCD). METHODS: In a cross-sectional study followed by a one-year matched longitudinal cohort, all 569 men hospitalized with AMI in all Cardiac Care Units (CCU) of Isfahan, Iran, were recruited in a six-month period. In addition, 123 out-of-hospital deaths were included that were diagnosed as SCD at the same duration. Among those discharged alive, 126 opium dependents were matched with 126 nondependents (mostly nonusers) according to age and smoking status, and were followed for one year. Opium dependence was measured using the ICD10 criteria and Severity of Dependence Scale (SDS) questionnaire. The method was validated by morphine blood levels. Biochemical measurements, blood pressure, blood cell counts, anthropometrics, and ejection fraction were measured at baseline and repeated at the end of follow-up. RESULTS: There were 118 (17.1%) patients with an average of 17.4 ± 10.4 years of abuse who met the criteria for opium dependency. Opium dependence decreased the age at event by 3.6 (95% CI: 1.2 - 6.0) years and was independent of smoking (P = 0.003). In terms of cardiovascular risk factors such as ejection fraction, in addition to post-AMI mortality and morbidity, no significant associations were noted at baseline or after one year of follow-up. The odds ratio of sustained smoking after AMI was 1.92 (95% CI: 1.04 - 3.52) in opium dependents (P = 0.033). CONCLUSION: Despite public opinion, opium did not improve cardiovascular risk factors, or post-AMI mortality and morbidity. Conversely, there were irrefutable findings regarding the detrimental effects of opium dependence. SN - 1735-3947 UR - https://www.unboundmedicine.com/medline/citation/23432167/Opium_decreases_the_age_at_myocardial_infarction_and_sudden_cardiac_death:_a_long__and_short_term_outcome_evaluation_ L2 - http://www.ams.ac.ir/AIM/NEWPUB/13/16/3/007.pdf DB - PRIME DP - Unbound Medicine ER -