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. 2024 Apr 24;19(1):38.
doi: 10.5334/gh.1315. eCollection 2024.

Long-Term Effects of Opium Consumption Following Percutaneous Coronary Intervention: A 10-year Follow-Up Study

Ali Izadi Amoli  1 , Alireza Oraii  1 , Faezeh Aghajani  2 , Mana Jameie  1 , Zahra Lotfi  1 , Arash Jalali  3 , Akbar Shafiee  3 , Mohammad Sadeq Najafi  1 , Masoumeh Lotfi-Tokaldany  1 , Seyedeh Hamideh Mortazavi  1 , Mojgan Ghavami  1 , Ignacio J Amat-Santos  4 , Mohammad Hadi Mansouri  2 , Hassan Aghajani  1
Affiliations

Long-Term Effects of Opium Consumption Following Percutaneous Coronary Intervention: A 10-year Follow-Up Study

Ali Izadi Amoli et al. Glob Heart. .

Abstract

Background: Opium consumption has been an overlooked health issue in the Iranian population, and the prognostic role of opium consumption in patients undergoing coronary revascularization is unknown.

Hypothesis: We aimed to assess the association between opium consumption and long-term cardiovascular outcomes after percutaneous coronary intervention (PCI).

Methods: We screened 2203 consecutive patients who underwent elective PCI between April 2009 and April 2010 at Tehran Heart Center. Exclusion criteria were unsuccessful PCI, non-elective PCI, and missing opium use data. Opium consumption was defined as self-reported ever use of any traditional opium substances. Outcomes of interest were all-cause mortality and a composite of major adverse cardiac and cerebrovascular events (MACCE). The association between opium use and study outcomes was evaluated using the inverse probability of treatment weighting (IPTW) method. Cumulative hazard curves were demonstrated to further assess the association visually. Furthermore, the effect of opium consumption on individual components of MACCE was evaluated in a competing risk setting.

Results: A total of 2025 elective PCI patients were included (age: 58.7 ± 10.67, 29.1% women), among whom 297 (14.6%) patients were opium users. After a median follow-up of 10.7 years, opium consumption was associated with a higher risk of all-cause mortality (IPTW-hazard ratio [HR] = 1.705, 95% CI: 1.125-2.585; P = 0.012) and MACCE (IPTW-HR = 1.578, 95% CI: 1.156-2.153; P = 0.004). The assessment of MACCE components suggested a non-significant borderline trend for higher non-fatal myocardial infarction (IPTW-sub-distribution HR [SHR] = 1.731, 95% CI: 0.928-3.231; P = 0.084) and mortality (IPTW-SHR = 1.441, 95% CI: 0.884-2.351; P = 0.143) among opium users.

Conclusions: Opium consumption is associated with a more than 50% increase in long-term risk of mortality and MACCE in patients undergoing PCI. These findings accentuate the importance of preventive strategies to quit opium addiction in this population.

Keywords: Percutaneous coronary intervention; all-cause mortality; coronary artery disease; major adverse cardiac and cerebrovascular event; opium.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Graphical Abstract
Abbreviations: CI, confidence interval; IPTW, inverse probability of treatment weighting; HR, hazard ratio; PCI, percutaneous coronary intervention
Flow diagram of the study population
Figure 1
Flow diagram of the study population. Abbreviations: CABG, coronary artery bypass graft; PCI, percutaneous coronary intervention.
Adjusted cumulative hazard of all-cause mortality (A) and major adverse cardio-cerebrovascular events (B) in patients with and without opium consumption
Figure 2
Adjusted cumulative hazard of all-cause mortality (A) and major adverse cardio-cerebrovascular events (B) in patients with and without opium consumption.
See this image and copyright information in PMC

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