Coronary artery disease and opioid use.
Over the past 20 years, we have observed a paucity of morbidity and mortality due to cardiovascular disease among drug users in a methadone maintenance clinic. The present study investigated whether long-term exposure to opiates or opioids is associated with decreased severity of coronary artery disease (CAD) by comparing 98 decedents with methadone or opiates (M/O) in their blood at autopsy with 97 frequency-matched decedents without M/O. Severe CAD was found significantly less often in M/O-positive decedents (5 of 98) than in M/O-negative decedents (16 of 97). Multiple logistic regression analysis contrasting those with moderate or severe CAD to those with no or mild CAD yielded an odds ratio of 0.43 (95% confidence interval 0.20 to 0.94) for M/O positivity after adjustment for potential confounding. Long-term opiate exposure thus may mitigate CAD severity and its often fatal consequences.
Marmor
Michael
M
Department of Environmental Medicine, and Charney Division of Cardiology, New York University School of Medicine, 650 First Avenue, Room 560, New York, NY 10016-3240, USA. michael.marmor@med.nyu.edu
Penn
Arthur
A
Widmer
Kyle
K
Levin
Richard I
RI
Maslansky
Robert
R
D000328:Adult; D001344:Autopsy; D003324:Coronary Artery Disease / Q000453:epidemiology* / Q000209:etiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000150:complications*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016320:Substance Abuse Treatment Centers