The United States is in the kernel of cataclysmic opioid misuse epidemic with over
33,000 deaths per year from both prescription and illegal opioids use. One of the
most common pernicious effects of opioids is on the cardiovascular system. The purpose
of this analysis was to determine the incidence of opioid overdose associated cardiovascular
events and its impact on short-term outcomes. This was a retrospective, observational
study which utilized data from the National Inpatient Sample from January 2005 to
September 2015 using International Classifications of Disease, Ninth Revision, Clinical Modification diagnosis codes to identify patients with opioid overdose and associated cardiovascular
outcomes. Cardiovascular events were mainly divided into the following 3 parts: Ischemic
Events (ischemic stroke and myocardial infarction), acute heart failure, and arrhythmias.
The primary outcome of this study was incidence of any cardiovascular event. This
study analyzed a total of 430,459 patients hospitalized with opioid overdose, out
of which 36,837 (8.6%) had at least 1 cardiovascular event. In all the opioid overdose
hospitalizations, 13,979 (3.2%) developed ischemic events, 3,074 (0.7%) developed
acute heart failure, and 22,444 (5.2%) developed arrhythmia. Opioid overdose patients
with new-onset cardiovascular events had higher odds for in-hospital mortality (odds
ratio 4.55; 95% confidence interval 4.11 to 5.04, p <0.001) as compared to patients
without cardiovascular events in the multivariable-adjusted model. This study group
also demonstrated longer length of stay and higher cost of hospitalization associated
with opioid overdose and associated cardiovascular outcome. In conclusion, opioid
overdose is associated with higher rates of cardiovascular events, particularly ischemic
events and cardiac arrhythmias. These adverse events eventually lead to higher mortality
rates and more resource utilization.
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Article Info
Publication History
Published online: August 23, 2019
Received in revised form:
July 26,
2019
Received:
June 20,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
