Opium Consumption and Myocardial Infarction in Osteoarthritis Patients: A Propensity Score Matched Cohort Study

In recent years, the use of drugs with opioid compounds in patients with osteoarthritis has attracted increasing attention. However, long-term use of these drugs may cause severe side effects, including cardiovascular diseases. The present study aimed to investigate the relationship between the use of opium substances and myocardial infarction in osteoarthritis patients using a propensity score matching (PSM) approach.

We designed this study as a retrospective cohort study. The data were collected from 2016 to 2020. We identified confounding variables using the modified disjunctive cause criterion method. We matched individuals exposed to opium (opium users) and those unexposed to opium (non-users) by propensity score. We examined the distributions of opium users and non-users, both with and without propensity score matching. To determine the relationship between exposure to opium and heart attack in osteoarthritis patients, the Cox regression method was used.

The participants' mean age was 49.85±9.61 years, with 32.3% being men and 67.7% being women. We excluded individuals with cardiovascular disease from the baseline examination. Before PSM, the incidence rate in the total study sample was 2.96 per 1000 person-years. The relationship between opium consumption and heart attack was inverse before matching (hazard ratio, HR 0.73, 95% confidence interval (95% CI 0.58-0.98). After matching, the HR showed an increase of 24% (HR 1.24, 95% CI 0.87-1.76).

The findings of the present study suggest that opioid consumption is associated with an increased risk of heart attacks in osteoarthritis patients. Confirmation of this finding in future studies would indicate the need for monitoring these patients with a view towards primary prevention of modifiable cardiovascular risk factors.