ABSTRACT
Background: opium dependence is a recognized individual and public health threat, but little is known about its association with acute myocardial infarction [AMI] or sudden cardiac death [SCD]
Methods: in a cross-sectional study followed by a one-year matched longitudinal cohort, all 569 men hospitalized with AMI in all Cardiac Care Units [CCU] of Isfahan, Iran, were recruited in a six-month period. In addition, 123 out-of-hospital deaths were included that were diagnosed as SCD at the same duration. Among those discharged alive, 126 opium dependents were matched with 126 nondependents [mostly nonusers] according to age and smoking status, and were followed for one year. Opium dependence was measured using the ICD10 criteria and Severity of Dependence Scale [SDS] questionnaire. The method was validated by morphine blood levels. Biochemical measurements, blood pressure, blood cell counts, anthropometrics, and ejection fraction were measured at baseline and repeated at the end of follow-up
Results: there were 118 [17.1%] patients with an average of 17.4 +/- 10.4 years of abuse who met the criteria for opium dependency. Opium dependence decreased the age at event by 3.6 [95% CI: 1.2 6.0] years and was independent of smoking [P = 0.003]. In terms of cardiovascular risk factors such as ejection fraction, in addition to post-AMI mortality and morbidity, no significant associations were noted at baseline or after one year of follow-up. The odds ratio of sustained smoking after AMI was 1.92 [95% CI: 1.04 3.52] in opium dependents [P = 0.033]
Conclusion: despite public opinion, opium did not improve cardiovascular risk factors, or post-AMI mortality and morbidity. Conversely, there were irrefutable findings regarding the detrimental effects of opium dependence