Comparing cardiovascular factors in opium abusers and non-users candidate for coronary artery bypass graft surgery


1 Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Psychiatry, Tehran Institute of Psychiatry-Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran


Background: In some opinions, opium consumption has traditionally been considered to be a means to lower blood lipids and to put off heart diseases. In this study, the relationship between opium consumption and risk factors of coronary artery diseases, hemodynamic factors and cardiac related functions before and after surgery was evaluated.
Materials and Methods: In a cross-sectional study 325 patient's candidate for elective coronary artery bypass grafting were enrolled in a period of 6 months. Opium addicted patients were recognized based on taking history from the patients by an anaesthesiologist. Serum lipid profile was determined at the beginning of the study. Frequency and distribution of coronary artery diseases were assessed according to the pre-operative coronary angiography.
Results: From 325 patients, 117 patients were opium abusers and 208 patients were not. Mean duration of opium abuse was 12.6 ± 7.7 years. Mean total serum cholesterol levels were not significantly different in abusers and non-users patients (185 ± 47 vs. 190 ± 49, P > 0.05). Mean level of low-density lipoprotein cholesterol was significantly higher in addicted group (121 ± 27 vs. 81 ± 22, P < 0.05). Mean triglyceride level was also higher in addicted patients (203 ± 114 vs. 162 ± 98, P < 0.05). The prevalence of diabetes and glucose levels was considerably lower in opium addicted cases. Mean body mass index was also lower in addicted patients significantly (25.3 ± 3.7 vs. 27.5 ± 4.1, P < 0.05).
Conclusion: There may be a relationship between opium abuse and aggravating lipid profile and hypercholesterolemia and coronary artery disease.


International Narcotics Control Strategy Report (INSCR), US Department of State 2004.  Back to cited text no. 1
Kalant H. Opium revisited: A brief review of its nature, composition, non-medical use and relative risks. Addiction 1997;92:267-77.  Back to cited text no. 2
Abd Elahi MH, Forouzannia SK, Zare SA. Demografic characteristics of opioid addiction in patients undergoing coronary artery bypass graft. Tehran Univ Med J 2007;64:55-60.  Back to cited text no. 3
Schultz JE, Gross GJ. Opioids and cardioprotection. Pharmacol Ther 2001;89:123-37.  Back to cited text no. 4
Pur-Shahriari AA, Mills RA, Hoppin FG Jr, Dexter L. Comparison of chronic and acute effects of morphine sulfate on cardiovascular function. Am J Cardiol 1967;20:654-9.  Back to cited text no. 5
Martell BA, Arnsten JH, Krantz MJ, Gourevitch MN. Impact of methadone treatment on cardiac repolarization and conduction in opioid users. Am J Cardiol 2005;95:915-8.  Back to cited text no. 6
Misra P, Caldito GC, Kakkar AK, Mancini MC, Reddy PC. Outcomes of coronary artery bypass grafting in patients with a history of illicit drug use. Am J Cardiol 2003;92:593-5.  Back to cited text no. 7
Othmer E, Othmer SC. The clinical Interview Using DSM-IV-TR Fundamentals. 1 st ed. Vol. 1. Washington, DC: American Psychiatric Publishing; 2002.  Back to cited text no. 8
Kouros D, Tahereh H, Mohammadreza A, Minoo MZ. Opium and heroin alter biochemical parameters of human's serum. Am J Drug Alcohol Abuse 2010;36:135-9.  Back to cited text no. 9
Shirani S, Shakiba M, Soleymanzadeh M, Esfandbod M. Can opium abuse be a risk factor for carotid stenosis in patients who are candidates for coronary artery bypass grafting? Cardiol J 2010;17:254-8.  Back to cited text no. 10
Karam GA, Reisi M, Kaseb AA, Khaksari M, Mohammadi A, Mahmoodi M. Effects of opium addiction on some serum factors in addicts with non-insulin-dependent diabetes mellitus. Addict Biol 2004;9:53-8.  Back to cited text no. 11
Mohammadi A, Darabi M, Nasry M, Saabet-Jahromi MJ, Malek-Pour-Afshar R, Sheibani H. Effect of opium addiction on lipid profile and atherosclerosis formation in hypercholesterolemic rabbits. Exp Toxicol Pathol 2009;61:145-9.  Back to cited text no. 12
Davoodi G, Sadeghian S, Akhondzadeh S, Darvish S, Alidoosti M, Amirzadegan A. Comparison of specifications, short-term outcome and prognosis of acute myocardial infarction in opium dependent patients and non-dependents. Ger J Psychiatry 2005;8:33-7.  Back to cited text no. 13
Sadeghian S, Darvish S, Davoodi G, Salarifar M, Mahmoodian M, Fallah N, et al. The association of opium with coronary artery disease. Eur J Cardiovasc Prev Rehabil 2007;14:715-7.  Back to cited text no. 14
Azimzade-Sarwar B, Yousefzade G, Narooey S. A case-control study of effect of opium addiction on myocardial infarction. Am J Appl Sci 2005;2:1134-5.  Back to cited text no. 15
Spinella M. The Psychopharmacology of Herbal Medicine. Massachusetts: The MIT Press; 2001.  Back to cited text no. 16
Asgary S, Sarrafzadegan N, Naderi GA, Rozbehani R. Effect of opium addiction on new and traditional cardiovascular risk factors: Do duration of addiction and route of administration matter? Lipids Health Dis 2008;7:42.  Back to cited text no. 17
Molina PE, Hashiguchi Y, Ajmal M, Mazza M, Abumrad NN. Differential hemodynamic, metabolic and hormonal effects of morphine and morphine-6-glucuronide. Brain Res 1994;664:126-32.  Back to cited text no. 18
Ipp E, Schusdziarra V, Harris V, Unger RH. Morphine-induced hyperglycemia: Role of insulin and glucagon. Endocrinology 1980;107:461-3.  Back to cited text no. 19
Kamei J, Sodeyama M, Ohsawa M, Kimura M, Tanaka S. Modulation by serum glucose levels on morphine-induced antinociceptive effect in C57BL/KsJ-db/db mice. Life Sci 1998;62:PL1-6.  Back to cited text no. 20
Hashiguchi Y, Molina PE, Abumrad NN. Modulation of metabolic effects of morphine-6-glucuronide by morphine-3-glucuronide. Brain Res Bull 1995;38:325-9.  Back to cited text no. 21
Barham D, Trinder P. An improved colour reagent for the determination of blood glucose by the oxidase system. Analyst 1972;97:142-5.  Back to cited text no. 22
Sadeghian S, Karimi A, Dowlatshahi S, Ahmadi SH, Davoodi S, Marzban M, et al. The association of opium dependence and postoperative complications following coronary artery bypass graft surgery: A propensity-matched study. J Opioid Manag 2009;5:365-72.  Back to cited text no. 23
Chen YT, Lin CJ, Lee AY. Plasma levels of endogenous opioid peptides in patients with acute myocardial infarction. Jpn Heart J 1995;36:421-7.  Back to cited text no. 24
Afraz MR. Comparison of opium addiction in silent with non-silent myocardial infarction. Med Fac J Guilan Univ Med Sci 2002;11:1028-55.  Back to cited text no. 25
Sadr Bafghi M, Rafiei L, Bahadorzadeh SM, Namayandeh MH, Soltani M.H, Motafaker M, et al. Is opium addiction a risk factor for acute myocardial infarction? Acta Med Iran 2005;43:218-22.  Back to cited text no. 26
Phillips GB, Pinkernell BH, Jing TY. The association of hypotestosteronemia with coronary artery disease in men. Arterioscler Thromb 1994;14:701-6.  Back to cited text no. 27
Genazzi AR. Hormone Replacement Therapy and Cardiovascular Disease, The Current Status of Research and Practice. London: CRC Press; 2001. p. 113.  Back to cited text no. 28
Sadeghian S, Graili P, Salarifar M, Karimi AA, Darvish S, Abbasi SH. Opium consumption in men and diabetes mellitus in women are the most important risk factors of premature coronary artery disease in Iran. Int J Cardiol 2010;141:116-8.  Back to cited text no. 29
Maisel WH, Rawn JD, Stevenson WG. Atrial fibrillation after cardiac surgery. Ann Intern Med 2001;135:1061-73.  Back to cited text no. 30
Villareal RP, Hariharan R, Liu BC, Kar B, Lee VV, Elayda M, et al. Postoperative atrial fibrillation and mortality after coronary artery bypass surgery. J Am Coll Cardiol 2004;43:742-8.  Back to cited text no. 31
Creswell LL, Schuessler RB, Rosenbloom M, Cox JL. Hazards of postoperative atrial arrhythmias. Ann Thorac Surg 1993;56:539-49.  Back to cited text no. 32
Aranki SF, Shaw DP, Adams DH, Rizzo RJ, Couper GS, VanderVliet M, et al. Predictors of atrial fibrillation after coronary artery surgery. Current trends and impact on hospital resources. Circulation 1996;94:390-7.  Back to cited text no. 33
Meybodi FA, Eslick GD, Sasani S, Abdolhoseyni M, Sazegar S, Ebrahimi F. Oral opium: An unusual cause of lead poisoning. Singapore Med J 2012;53:395-7.  Back to cited text no. 34