title: Opium consumption and coronary atherosclerosis in diabetic patients: a propensity score-matched study.
abstract: There is a traditional belief among Eastern people that opium may have ameliorating effects on cardiovascular risk factors, especially diabetes; thus, it is widely used among diabetic patients. We attempted to investigate the association of opium consumption with coronary artery disease (CAD) in diabetic patients. A cross-sectional study was conducted on diabetic patients undergoing coronary angiography in our center. Out of 1925 diabetic patients included in the study, 228 were opium users, and the remaining 1697 non-opium users were used as a pool of potential comparators. Propensity scores were used to match the 228 opium consumers with 228 matched comparators for age, sex, and smoking status. The Gensini score and extent score were respectively used to assess the angiographic severity and extent of CAD. The mean Gensini score (86.9 ± 62.7 vs. 59.6 ± 43.4, p < 0.0001) and extent score (7.1 ± 2.9 vs. 5.9 ± 2.9, p < 0.0001) were significantly higher in opium user diabetic patients than in non-opium users. After adjustment for potential confounders, a dose-response relationship was observed between dose of opium and the Gensini score ( β = 0.27, p = 0.04). There were no significant differences between the routes of opium administration (inhalation vs. oral) regarding the severity and extent of CAD. In conclusion, exposure to opium in diabetic patients may be positively associated with the risk of CAD, and with the angiographically determined severity and extent of the disease. Furthermore, dosage of opium consumption may correlate with severity of CAD.
authors.affiliation: Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Kianoosh
authors.initials: SK
authors.lastname: Hosseini
authors.forename: Farzad
authors.initials: F
authors.lastname: Masoudkabir
authors.forename: Ali
authors.initials: A
authors.lastname: Vasheghani-Farahani
authors.forename: Saeed
authors.initials: S
authors.lastname: Alipour-Parsa
authors.forename: Mahmood
authors.initials: M
authors.lastname: Sheikh Fathollahi
authors.forename: Abbas
authors.initials: A
authors.lastname: Rahimi-Foroushani
authors.forename: Elham
authors.initials: E
authors.lastname: Hakki
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Goodarzynejad
authors.forename: Hassan
authors.initials: H
authors.lastname: Eftekhar
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000368:Aged; D016001:Confidence Intervals; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000139:chemically induced* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000139:chemically induced; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000150:complications*; D009892:Opium / Q000009:adverse effects*; D010207:Papaver / Q000737:chemistry*; D057216:Propensity Score; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors
chemical_list: D009892:Opium