Related Links
Statistics
| Number of Journals | 8 |
| Number of Issues | 52 |
| Number of Articles | 381 |
| Article View | 113,378 |
| PDF Download | 79,777 |
Comparative analysis of in-hospital outcomes in opioid-dependent vs. non-opioid-dependent STEMI patients | ||
| Cardiovascular Biomedicine | ||
| Volume 5, Issue 1, September 2025, Pages 24-30 PDF (610.52 K) | ||
| Document Type: original articles | ||
| DOI: 10.18502/cbj.v5i1.19449 | ||
| Authors | ||
| Razieh khakzar Bafrouei; Mohammad Hossein Soltani; Bita Baghshahi; Parisa Peigan* ; Farnoosh Ghomi | ||
| 1. Yazd Cardiovascular Research Center, Non- communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran | ||
| Abstract | ||
| Objectives: Myocardial infarction is a leading cause of death worldwide. The effect of opioid dependence on myocardial infarction outcomes remains uncertain, with conflicting results in the literature. This study aimed to assess the in-hospital and six-month outcomes of opioid-dependent compared to non-dependent patients with ST-elevation myocardial infarction (STEMI) at Afshar Heart Center, Yazd. Methods: This cross-sectional analytical study included 200 STEMI patients admitted to Afshar Heart Center in Yazd, Iran, between 2020 and 2021. Patients were divided into opioid-dependent and non-opioid-dependent groups based on the DSM-IV criteria for opioid use. The inclusion criteria were chest pain lasting at least 30 minutes, specific ST-segment elevation on ECG, and elevated serum creatine kinase levels. Patients with a history of myocardial infarction or other cardiac or pulmonary diseases were excluded. Demographic and clinical data were collected from hospital records and analyzed using SPSS v.22. Results: Multivariate analysis showed that opioid dependence was significantly linked to in-hospital outcomes. Although in-hospital mortality was higher for opioid-dependent patients compared to non-dependent patients (8.3% vs. 1.7%, p = 0.34), this difference was not statistically significant. Interestingly, six-month mortality occurred only in the non-dependent group (3.4% vs. 0%, p = 0.095). The duration from symptom onset to hospital arrival was considerably shorter in opioid users (154.01 ± 190.38 minutes) than in non-users (271.62 ± 287.58 minutes, p < 0.01), which may have contributed to earlier reperfusion. Despite these differences, there were no significant differences between the groups regarding revascularization strategies or left ventricular ejection fraction (EF: 38.15% vs. 38.52%, p = 0.974). Conclusions: Opioid dependency greatly affects the prognosis of STEMI patients, highlighting the importance of targeted interventions and additional research. | ||
| Keywords | ||
| Opioid addiction; ST-elevation myocardial infarction; myocardial infarction | ||
| References | ||
|
1.Vaduganathan M, Mensah GA, Turco JV, et al. The global burden of cardiovascular diseases and risk: a compass for future health. J Am Coll Cardiol. 2022; 80(25):2361-2371.
2.Nalini M, Shakeri R, Poustchi H, et al. Long-term opiate use and risk of cardiovascular mortality: results from the Golestan Cohort Study. Eur J Prev Cardiol. 2021;28(1):98-106.
3.Masoudkabir F, Sarrafzadegan N, Eisenberg MJ. Effects of opium consumption on cardiometabolic diseases. Nat Rev Cardiol. 2013;10(12):733-40.
4.Gross ER, Hsu AK, Gross GJ. Opioid-induced cardioprotection occurs via glycogen synthase kinase β inhibition during reperfusion in intact rat hearts. Circ Res. 2004;94 (7):960-6.
5.Dehghani F, Masoomi M, Haghdoost AA. Relation of opium addiction with the severity and extension of myocardial infarction and its related mortality. Addict Health. 2013;5(1-2):35-42.
6.Davoodi G, Sadeghian S, Akhondzadeh S, et al. Comparison of specifications, short term outcome and prognosis of acute myocardial infarction in opium dependent patients and nondependents. JTHC. 2006;1(1):48-53.
7.Javadi HR, Allami A, Mohammadi N, et al. Opium dependency and in-hospital outcome of acute myocardial infarction. Med J Islam Repub Iran. 2014;28:122.
8.Azdaki N, Bady SAM, Kazemi T, et al. Opium Addiction and Coagulation Factors in ST-Segment Elevation Myocardial Infarction (STEMI) Patients: Implications for Thrombosis and Cardiovascular Outcomes. Iran J Public Health. 2025;54(3): 654-662.
9.Romano JG, Muller N, Merino JG, et al. In-hospital delays to stroke thrombolysis: paradoxical effect of early arrival. Neurol Res. 2007;29(7):664-6.
10.Darabad BR, Vatandust J, Khoshknab MP, et al. Survey of the effect of opioid abuse on the extent of coronary artery diseases. Glob J Health Sci.2014;6(7):83-91.
11.Ascandar N, Vadlakonda A, Verma A, et al. Association of opioid use disorder with outcomes of hospitalizations for acute myocardial infarction in the United States. Clinics (Sao Paulo). 2023;78: 100251.
12.Saberi M, Marefat R, Tajali AB. Home Browse Journal Info Guide for Authors Submit Manuscript Reviewers Contact Us Author Services Copyright Ownership Impact of Organizational Maturity on Acceptance and Use of Technology Among Library and Information Science Experts in the Public Libraries of Mashhad. I J I S M. 2024;22(3).
13.Najafipour H, Masoumi M, Amirzadeh R, et al. Trends in the prevalence and incidence of opium abuse and its association with coronary artery risk factors in adult population in Iran: findings from Kerman coronary artery disease risk factors study. Iran J Med Sci. 2022;47(4): 328-337.
14.Singleton JH, Abner EL, Akpunonu PD, et al. Association of nonacute opioid use and cardiovascular diseases: a scoping review of the literature. J Am Heart Assoc. 2021;10(13):e021260.
15.Upur H, Li J-L, Zou X-G, et al. Short and long-term prognosis of admission hyperglycemia in patients with and without diabetes after acute myocardial infarction: a retrospective cohort study. Cardiovasc Diabetol. 2022;21(1):114.
16.Saxena J, Chilakapati R, Attia P, et al. Body Mass Index Trends among a Cohort of Subjects Enrolled in Medication-Assisted Treatment Programmes for Opioid Use Disorder: Racial/Ethnic, Gender, and Age Differences. J Food Nutr Metab.2023;5(1):10.
17.Vallecillo G, Pedro‐Botet J, Fernandez S, et al. High cardiovascular risk in older patients with opioid use disorder: differences with the general population. Drug Alcohol Rev. 2022;41(5):1078-1084.
18.Connelly PJ, Azizi Z, Alipour P, et al. The importance of gender to understand sex differences in cardiovascular disease. Can J Cardiol. 2021;37(5):699-710.
19.Kim MS, Hwang J, Yon DK, et al. Global burden of peripheral artery disease and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Glob Health. 2023;11 (10):e1565.
20.Rohani F, Rezayat AA, Zarifian A, et al. Opioid dependency and myocardial infarction: a systematic review and meta-analysis. Curr Rev Clin Exp Pharmacol. 2021;16(4):330-340.
21.Toska E, Mayrovitz HN. Opioid impacts on cardiovascular health. Cureus.2023;15 (9):e46224.
22.Shen TS, Rodriguez S, LeBrun DG, et al. Reasons and risk factors for failed same-day discharge after primary total knee arthroplasty. J Arthroplasty. 2023;38(4):668-672. | ||
|
Statistics Article View: 68 PDF Download: 22 |
||