# How Does Opium Dependency Affect the Myocardial Infarction Outcomes?: -

## TL;DR

The study found that opium dependence is linked to more severe heart disease in patients with acute coronary syndrome, but did not significantly affect mortality.

## Contribution

This study provides new insights into the clinical impact of opium dependence on acute coronary syndrome outcomes in a specific population.

## Key findings

- Opium-dependent patients had more severe coronary artery disease compared to non-opium-dependent patients.
- Initial heart function recovery was faster in opium-dependent patients, but long-term mortality was not significantly different.

## Abstract

Acute Coronary Syndrome (ACS) remains a leading global cause of
mortality, with multiple established risk factors. While smoking is widely
recognized, opium use poses a significant health concern, particularly in
developing nations. Despite traditional beliefs suggesting potential
cardioprotective effects, growing evidence indicates a detrimental impact of
opium consumption on cardiovascular health. This study aimed to investigate
the
association between opium dependence and the clinical outcomes of patients
experiencing ACS.

This study, conducted on 165 patients
with ST-elevation myocardial infarction (STEMI) and Non-ST-elevation
myocardial
infarction (NSTEMI) referred to the Qom Heart Center, Qom, Iran from 2022 to
2024. The patients were categorized in two groups: 81 opium-dependent
patients
based on DSM-V criteria as a case group and 84 non-opium-dependent patients
as a
control group, and their clinical outcomes were compared.

Coronary
artery involvement was significantly more severe in opium-dependent patients
ie
three vessel disease (3VD) or left main stenosis (LM) involvement in the
opium-dependent group was 48.1% versus 28.6% in the non-opium-dependent
group,
(P-value=0.01). Prevalence of atrial fibrillation (AF) and delay in hospital
admission and the hospitalization days were higher in the opium-dependent
group.
LVEF at the admission did not differ between the two groups, but left
ventricle
ejection fraction (LVEF) three months later was higher in the
opium-dependent
group. Rehospitalization, arrhythmia, mechanical complications, need for
CABG,
and mortality during the initial hospitalization did not differ between the
two
groups. The mortality of the patients in the six-month follow-up was 6.5% in
the
opium-dependent group and 8.6% in the non-opium-dependent group
(P-value=0.61)
which did not show a significant difference. This issue shows the lack of
significant role of opium consumption in the mortality of patients.

Our findings suggest a strong association between opium dependence and a more
severe clinical presentation of ACS, characterized by a higher burden of
coronary artery disease. Although initial LVEF recovery appeared faster in
opium-dependent individuals, the overall impact on long-term mortality
remained
inconclusive within the six-month follow-up period. These findings
underscore
the critical need for further research to elucidate the complex interplay
between opium dependence and cardiovascular outcomes in ACS patients,
including
long-term follow-up and exploration of potential underlying mechanisms.