Abstract
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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Morphine enhances pharmacological preconditioning by isoflurane.Anesthesiology. 2003; 98: 705-711
- Adenosine and opioid receptor-mediated cardioprotection in the rat.Am J Physiol Heart Circ Physiol. 2003; 285: H81-H89
- Opiate drugs and delta-receptor-mediated myocardial protection.Circulation. 1999; 100: II357-II360
- Protection of cardiac myocytes via delta-1 opioid receptors, protein kinase C and mitochondrial K+ATP channels.Am J Physiol. 2001; 280: H377-H383
- Opioid Analgesics and Antagonists.in: Hardman J.G Limbird L.E Molinoff P.B Ruddon R.W Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th Ed. McGraw-Hill, New York1996: 521-555
- Methadone and heroin antinociception.Jpn J Pharmacol. 2002; 88: 319-331
- Mu and delta receptors belong to a family of receptors that are coupled to potassium channels.Proc Natl Acad Sci USA. 1987; 84: 5487-5491
- Differential regulation by cAMP-dependent protein kinase of the mu opioid receptor coupling to a G protein-activated K+ channel.J Biol Chem. 1994; 269: 7839-7842
- Chi-square tests with one degree of freedom.J Am Stat Assoc. 1963; 58: 690-700
- Egret for Windows Version 2.0.3. Cytel Software Corp, Cambridge, MA2000
- Modulation of peripheral inflammation by locally administered hemorphin-7.Inflamm Res. 1998; 47: 49-55
- Peripheral mechanisms of opioid antinociception in inflammation.Eur J Pharmacol. 1993; 242: 229-235
- The pathogenesis of atherosclerosis.Nature. 1993; 362: 801-809
- Inflammation and atherosclerosis.Circulation. 2002; 105: 1135-1143
- Prolonging the delayed phase of myocardial protection.J Am Coll Cardiol. 1998; 31: 1142-1149
- Activation of epsilon protein kinase C correlates with a cardioprotective effect of regular ethanol production.Proc Natl Acad Sci USA. 1998; 95: 8262-8267
- Moderate alcohol consumption induces sustained cardiac protection by activating PKC-epsilon and Akt.Am J Physiol. 2002; 283: H165-H174
- Hypocholesterolemia in substance abusers.South Med J. 1991; 84 (letter): 937
Article info
Publication history
Accepted:
January 29,
2004
Received in revised form:
January 29,
2004
Received:
September 30,
2003
Footnotes
☆This work was supported in part by grant 1 R01 DA 15303 from the National Institute on Drug Abuse, Bethesda, Maryland, and a Grant-in-Aid from the American Heart Association (Southeast Affiliate), Marietta, Georgia.
Identification
Copyright
© 2004 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.