Long-term opiate use and risk of cardiovascular mortality : results from the Golestan Cohort Study
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com..
AIMS: Tens of millions of people worldwide use opiates but little is known about their potential role in causing cardiovascular diseases. We aimed to study the association of long-term opiate use with cardiovascular mortality and whether this association is independent of the known risk factors.
METHODS AND RESULTS: In the population-based Golestan Cohort Study-50 045 Iranian participants, 40-75 years, 58% women-we used Cox regression to estimate hazard ratios and 95% confidence intervals (HRs, 95% CIs) for the association of opiate use (at least once a week for a period of 6 months) with cardiovascular mortality, adjusting for potential confounders-i.e. age, sex, education, wealth, residential place, marital status, ethnicity, and tobacco and alcohol use. To show independent association, the models were further adjusted for hypertension, diabetes, waist and hip circumferences, physical activity, fruit/vegetable intake, aspirin and statin use, and history of cardiovascular diseases and cancers. In total, 8487 participants (72.2% men) were opiate users for a median (IQR) of 10 (4-20) years. During 548 940 person-years-median of 11.3 years, >99% success follow-up-3079 cardiovascular deaths occurred, with substantially higher rates in opiate users than non-users (1005 vs. 478 deaths/100 000 person-years). Opiate use was associated with increased cardiovascular mortality, with adjusted HR (95% CI) of 1.63 (1.49-1.79). Overall 10.9% of cardiovascular deaths were attributable to opiate use. The association was independent of the traditional cardiovascular risk factors.
CONCLUSION: Long-term opiate use was associated with an increased cardiovascular mortality independent of the traditional risk factors. Further research, particularly on mechanisms of action, is recommended.
| Errataetall: |
CommentIn: Eur J Prev Cardiol. 2022 May 6;29(6):e237-e238. - PMID 34718505 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
European journal of preventive cardiology - 28(2021), 1 vom: 23. März, Seite 98-106 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nalini, Mahdi [VerfasserIn] |
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| Links: |
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| Themen: |
Adverse effects |
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| Anmerkungen: |
Date Completed 10.12.2021 Date Revised 24.03.2024 published: Print CommentIn: Eur J Prev Cardiol. 2022 May 6;29(6):e237-e238. - PMID 34718505 Citation Status MEDLINE |
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| doi: |
10.1093/eurjpc/zwaa006 |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Nalini, Mahdi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-term opiate use and risk of cardiovascular mortality |b results from the Golestan Cohort Study |
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| 500 | |a Date Revised 24.03.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Eur J Prev Cardiol. 2022 May 6;29(6):e237-e238. - PMID 34718505 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a AIMS: Tens of millions of people worldwide use opiates but little is known about their potential role in causing cardiovascular diseases. We aimed to study the association of long-term opiate use with cardiovascular mortality and whether this association is independent of the known risk factors | ||
| 520 | |a METHODS AND RESULTS: In the population-based Golestan Cohort Study-50 045 Iranian participants, 40-75 years, 58% women-we used Cox regression to estimate hazard ratios and 95% confidence intervals (HRs, 95% CIs) for the association of opiate use (at least once a week for a period of 6 months) with cardiovascular mortality, adjusting for potential confounders-i.e. age, sex, education, wealth, residential place, marital status, ethnicity, and tobacco and alcohol use. To show independent association, the models were further adjusted for hypertension, diabetes, waist and hip circumferences, physical activity, fruit/vegetable intake, aspirin and statin use, and history of cardiovascular diseases and cancers. In total, 8487 participants (72.2% men) were opiate users for a median (IQR) of 10 (4-20) years. During 548 940 person-years-median of 11.3 years, >99% success follow-up-3079 cardiovascular deaths occurred, with substantially higher rates in opiate users than non-users (1005 vs. 478 deaths/100 000 person-years). Opiate use was associated with increased cardiovascular mortality, with adjusted HR (95% CI) of 1.63 (1.49-1.79). Overall 10.9% of cardiovascular deaths were attributable to opiate use. The association was independent of the traditional cardiovascular risk factors | ||
| 520 | |a CONCLUSION: Long-term opiate use was associated with an increased cardiovascular mortality independent of the traditional risk factors. Further research, particularly on mechanisms of action, is recommended | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Intramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Adverse effects | |
| 650 | 4 | |a Cardiovascular diseases | |
| 650 | 4 | |a Death | |
| 650 | 4 | |a Opioid | |
| 650 | 4 | |a Opium | |
| 650 | 7 | |a Opiate Alkaloids |2 NLM | |
| 700 | 1 | |a Shakeri, Ramin |e verfasserin |4 aut | |
| 700 | 1 | |a Poustchi, Hossein |e verfasserin |4 aut | |
| 700 | 1 | |a Pourshams, Akram |e verfasserin |4 aut | |
| 700 | 1 | |a Etemadi, Arash |e verfasserin |4 aut | |
| 700 | 1 | |a Islami, Farhad |e verfasserin |4 aut | |
| 700 | 1 | |a Khoshnia, Masoud |e verfasserin |4 aut | |
| 700 | 1 | |a Gharavi, Abdolsamad |e verfasserin |4 aut | |
| 700 | 1 | |a Roshandel, Gholamreza |e verfasserin |4 aut | |
| 700 | 1 | |a Khademi, Hooman |e verfasserin |4 aut | |
| 700 | 1 | |a Zahedi, Mahdi |e verfasserin |4 aut | |
| 700 | 1 | |a Abedi-Ardekani, Behnoush |e verfasserin |4 aut | |
| 700 | 1 | |a Vedanthan, Rajesh |e verfasserin |4 aut | |
| 700 | 1 | |a Boffetta, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Dawsey, Sanford M |e verfasserin |4 aut | |
| 700 | 1 | |a Pharaoh, Paul D |e verfasserin |4 aut | |
| 700 | 1 | |a Sotoudeh, Masoud |e verfasserin |4 aut | |
| 700 | 1 | |a Abnet, Christian C |e verfasserin |4 aut | |
| 700 | 1 | |a Day, Nicholas E |e verfasserin |4 aut | |
| 700 | 1 | |a Brennan, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Kamangar, Farin |e verfasserin |4 aut | |
| 700 | 1 | |a Malekzadeh, Reza |e verfasserin |4 aut | |
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