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The association of opium dependence and postoperative complications following coronary artery bypass graft surgery: A propensity-matched study

Saeed Sadeghian, MD, Abbasali Karimi, MD, Samaneh Dowlatshahi, MD, Seyed Hossein Ahmadi, MD, Saeed Davoodi, MD, Mehrab Marzban, MD, Namvar Movahedi, MD, Kyomars Abbasi, MD, Mokhtar Tazik, MD, Mahmood Sheikh Fathollahi, PhD

Abstract


Objective: Opium is an overwhelming public health problem in some countries. Different studies have suggested this drug as a risk factor for cardiovascular disease. Although the effect of opium on immune system, lung disease, nephropathy, stroke, and cardiac arrhythmia has been found in different studies, its effect on postoperation complications is not clear yet. The authors conducted this study to assess the effect of opium on post operation in hospital complications among patients who underwent coronary artery bypass graft.
Design: The authors retrospectively analyzed the data in this study.
Setting: This study has been done at Tehran Heart Center.
Patients: A total of 4,398 patients who had undergone isolated CABG were studied.
Main outcome measure: Patients who fulfilled the DSM-IV-TR criteria for opium dependence (by smoking) were enrolled as Opium Dependent Patients. Also outcome variables were: Perioperative MI, septicemia, UTI, TIA, continuous coma, prolonged ventilation, pulmonary embolism, renal failure, acute limb ischemia, heart block, AF, mortality.
Results: The prevalence of opium dependence was 15.6 percent among patients. The authors used a propensity matched model to analyze the relationship between opium and post operation complications. The authors adjusted opium and non-opium dependent patients in all of the baseline preoperative risk factors, so all of the matched patients were same and there was no bias in assessment.
Conclusion: Opium dependent patients had significantly longer resource utilization. However, no significant relationship was found between opium dependence and other cardiac and non cardiac in hospital complications.

Keywords


opium, coronary artery bypass grafting, addiction, postoperative complications

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References


Davoodi G, Sadeghian S, Akhondzadeh SH, et al.: Comparison of specifications, short-term outcome and prognosis of acute myocardial infarction in opium dependent patients and nondependents. German J Psychiatry. 2005; 8: 33-37.

Asghary S, Naderi GH, Soghraty M, et al.: A study of plasma lipid peroxidation, lipids and blood sugar level in opium addicts compared with control group. ARYA J. 2005; 1(2): 72-74.

Gorgaslidze AG, Saifullaeva MA, Kuzmina MM, et al.: Cardiac arrhythmia and myocardial contraction in opium and ephedrone addiction. Kardiologiia. 19993; 33(1): 14-16.

Bryant HU, Story JA, Yim GK: Morphine-induced alterations in plasma and tissue cholesterol levels. Life Sci. 1987; 41(5): 545-554.

Azarang A, Mahmoodi M, Rajabalian S, et al.: T-helper 1 and 2 serum cytokine assay in chronic opioid addicts. Eur Cytokine Netw. 2007; 18(4): 210-214.

McDonough RJ, Madden JJ, Falek A, et al.: Alteration of T and null lymphocyte frequencies in the peripheral blood of human opiate addicts: In vivo evidence for opiate receptor sites on T lymphocytes. J Immunol. 1980; 125(6): 2539-2543.

Da Costa JL, Tock EP, Boey HK: Lung disease with chronic obstruction in opium smokers in Singapore. Clinical, electrocardiographic, radiological, functional and pathological features. Thorax. 1971; 26(5): 555-571.

Lao PN: The effects of opiates on the lung. Clin Rev Allergy Immunol. 1997; 15(3): 291-305.

Ahmadi J, Benrazavi L: Substance use among Iranian nephrologic patients. Am J Nephrol. 2002; 22(1): 11-13.

Sauer CM: Recurrent embolic stroke and cocaine-related cardiomyopathy. Stroke. 1991; 22(9): 1203-1205.

Society of Thoracic Surgeons: STS Adult Cardiac Database. Definition of terms. Version 2.41. Society of Thoracic Surgeons. Available at www.Sts.org/file/CoreDef 241Book.Pdf. Accessed May, 2002.

Rosenbaum PR: Observational studies, 2nd ed. New York: Springer-Verlag, 2002.

D’Agostino RB Jr: Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998; 17(19): 2265-2281.

Efron B, Tibshirani RJ: An Introduction to the Bootstrap. Boca Raton, FL: Chapman & Hall/CRC, 1998.

Sadr Bafghi SM, Rafiei M, Bahadorzadeh L, et al.: Is opium addiction a risk factor for acute myocardial infarction? Acta Med Iran. 2005; 43(3): 218-222.

Abdollahi MH, Forouzan SKH, Zahreh S: Demographic characteristics of opioid addiction in patients undergoing coronary artery bypass graft. Terhran Univ Med J. 2007; 64(10): 54-59.

Marmor M, Penn A, Widmer K, et al.: Coronary artery disease and opiate use. Am J Cardiol. 2004; 93(10): 1295-1297.

Azimzade-Sarwar B, Yousefzade GH, Narooey SH: A case control study of effect of opium addiction on myocardial infarction. Am J Appl Sci. 2005; 2(7): 1134-1135.

Sadeghian S, Darvish S, Davoodi G, et al.: The association of opium with coronary artery disease. Eur J Cardiovasc Prev Rehabil. 2007; 14 (5): 715-717.

Mohammadi A, Darabi M, Nasry M, et al.: Effects of opium addiction on lipid profile and atherosclerosis formation in hypercholestrolemic rabbits. Exp Toxicol Pathol. 2008; 61(2): 145-149.

Yamauchi T, Shibata K, Uchiyama S, et al.: A case of cerebral infarction in a young adult following an abuse of cocaine and other drugs. Rinsho_Shinkeigaku. 1995; 35 (11): 1256-1258.

Bratĭchuk AN, Minarv IuL, Boklina AA, et al.: Surgical infection in drug dependands: Determination of severity degree and treatment-tactical characteristics. Voen Med Zh. 2006; 327(9): 38-41, 96.




DOI: https://doi.org/10.5055/jom.2009.0036

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