Is opium use a predictor factor for major adverse cardiovascular events in coronary angiography patients?

It is believed that opium, as a narcotic substance, may have protective effects against various disorders such as cardiovascular diseases. The association between opium use and the occurrence of major adverse cardiovascular events (MACE) in patients undergoing angiography was assessed in this study.

The present descriptive-analytical study was conducted on patients with suspected coronary artery disease (CAD) who underwent angiography at Razi Hospital, Birjand, Iran from June 2018 to November 2020. Participants were considered into two groups: Addicted (i.e. opium users) and non-opium users. Demographic information, medical history, history of opium use, and the SYNTAX score were collected.

A total of 2,759 individuals with a mean age of 60.12 ± 18.12 years (ranging from 18 to 94 years) were included. Among the participants, 59.4% were male, with 627 identified as opium users and 2,132 as non-users. The opium user group exhibited significantly lower body mass index (BMI), and frequency of diabetes mellitus and hypertension compared to the non-opium user group (p<0.001). Conversely, the incidence of stenosis ≥50%, moderate SYNTAX score, and MACE incidence were remarkably higher among opium users compared to non-users (p<0.01 to p<0.001). Logistic regression analyses indicated a significant relationship between age, SYNTAX score, prior percutaneous coronary intervention (PCI), and opium use with cardiovascular procedures.

These results indicate that opium use is associated with increased stenosis and SYNTAX score, as well as a higher incidence of myocardial infarction and PCI, thereby increasing the odds ratio for cardiovascular events.