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How Does Opium Dependency Affect the Myocardial Infarction Outcomes? :.

Shahriar Shirkhoda1, Somayyeh Norouzi1, Mansoor Namazi2

  • 1Department of Cardiology, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.

Galen Medical Journal
|April 27, 2026
PubMed
Summary

Opium dependence is linked to more severe coronary artery disease in Acute Coronary Syndrome (ACS) patients. While opium users showed faster initial heart function recovery, long-term mortality differences were not significant in this study.

Keywords:
Acute Coronary SyndromeArrhythmiasCoronary Artery DiseasesCoronary StenosisOpioid

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Area of Science:

  • Cardiology
  • Public Health
  • Addiction Medicine

Background:

  • Acute Coronary Syndrome (ACS) is a major cause of death globally, with various risk factors.
  • Opium use is a significant health concern, especially in developing countries, despite some traditional beliefs about its cardioprotective effects.
  • Emerging evidence suggests opium consumption negatively impacts cardiovascular health.

Purpose of the Study:

  • To investigate the association between opium dependence and clinical outcomes in patients experiencing ACS.
  • To compare the severity of coronary artery disease and patient outcomes between opium-dependent and non-dependent ACS patients.

Main Methods:

  • A comparative study involving 165 patients (81 opium-dependent, 84 non-dependent) diagnosed with ST-elevation myocardial infarction (STEMI) or Non-ST-elevation myocardial infarction (NSTEMI).
  • Patients were recruited from Qom Heart Center, Iran, between 2022 and 2024.
  • Opium dependence was assessed using DSM-V criteria, and clinical outcomes were compared between the two groups.

Main Results:

  • Opium-dependent patients exhibited significantly more severe coronary artery involvement (three-vessel disease or left main stenosis: 48.1% vs. 28.6%, P=0.01).
  • Higher prevalence of atrial fibrillation, delayed hospital admission, and longer hospitalization were observed in the opium-dependent group.
  • While initial left ventricle ejection fraction (LVEF) did not differ, LVEF was higher at three-month follow-up in opium-dependent patients; however, mortality and other adverse events did not differ significantly at six months.

Conclusions:

  • Opium dependence is associated with a more severe clinical presentation and greater coronary artery disease burden in ACS patients.
  • Faster initial recovery of LVEF was noted in opium-dependent individuals, but the long-term impact on mortality remains uncertain.
  • Further research is needed to understand the complex relationship between opium dependence and cardiovascular outcomes in ACS, including long-term follow-up and underlying mechanisms.