Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons
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Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons. / Liew, Stephanie M; Chowdhury, Enayet K; Ernst, Michael E; Gilmartin-Thomas, Julia; Reid, Christopher M; Tonkin, Andrew; Neumann, Johannes; McNeil, John J; Kaye, David M.
in: ESC HEART FAIL, Jahrgang 9, Nr. 6, 12.2022, S. 3973-3984.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Prescribed opioid use is associated with adverse cardiovascular outcomes in community-dwelling older persons
AU - Liew, Stephanie M
AU - Chowdhury, Enayet K
AU - Ernst, Michael E
AU - Gilmartin-Thomas, Julia
AU - Reid, Christopher M
AU - Tonkin, Andrew
AU - Neumann, Johannes
AU - McNeil, John J
AU - Kaye, David M
N1 - © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
PY - 2022/12
Y1 - 2022/12
N2 - AIMS: Prescribed opioids are commonly used in the older community-dwelling population for the treatment of chronic pain. Although the harmful effects of opioid abuse and overdose are well understood, little is known about the long-term cardiovascular (CV) effects of prescribed opioids. The aim of this study was to investigate the CV effects associated with prescribed opioid use.METHODS AND RESULTS: A post hoc analysis of participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial was conducted. Participants in the ASPREE trial included community-dwelling older adults without a prior history of CV disease (CVD). Prescribed opioid use was defined as opioid use at baseline and/or at the first annual visit (AV1). Cox proportional hazards regression was used to calculate hazard ratios and 95% confidence intervals (95% CI) for associations between opioid use and CVD events following AV1. Of the 17 701 participants included (mean age 75.2 years, 58.2% female), 813 took opioids either at baseline or at AV1. Over a median follow-up period of 3.58 years (IQR 2.50-4.62), CVD events, most notably heart failure hospitalization, occurred in 7% (n = 57) amongst opioid users and 4% (n = 680) amongst non-opioid users. After adjustment for multiple covariates, opiate use was associated with a 1.67-fold (CI 1.26-2.23, P < 0.001) increase in the hazard ratio for CVD events.CONCLUSIONS: These findings identify opioid use as a non-traditional risk factor for CVD events in community-dwelling older adults.
AB - AIMS: Prescribed opioids are commonly used in the older community-dwelling population for the treatment of chronic pain. Although the harmful effects of opioid abuse and overdose are well understood, little is known about the long-term cardiovascular (CV) effects of prescribed opioids. The aim of this study was to investigate the CV effects associated with prescribed opioid use.METHODS AND RESULTS: A post hoc analysis of participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial was conducted. Participants in the ASPREE trial included community-dwelling older adults without a prior history of CV disease (CVD). Prescribed opioid use was defined as opioid use at baseline and/or at the first annual visit (AV1). Cox proportional hazards regression was used to calculate hazard ratios and 95% confidence intervals (95% CI) for associations between opioid use and CVD events following AV1. Of the 17 701 participants included (mean age 75.2 years, 58.2% female), 813 took opioids either at baseline or at AV1. Over a median follow-up period of 3.58 years (IQR 2.50-4.62), CVD events, most notably heart failure hospitalization, occurred in 7% (n = 57) amongst opioid users and 4% (n = 680) amongst non-opioid users. After adjustment for multiple covariates, opiate use was associated with a 1.67-fold (CI 1.26-2.23, P < 0.001) increase in the hazard ratio for CVD events.CONCLUSIONS: These findings identify opioid use as a non-traditional risk factor for CVD events in community-dwelling older adults.
KW - Humans
KW - Female
KW - Aged
KW - Aged, 80 and over
KW - Male
KW - Independent Living
KW - Opioid-Related Disorders/epidemiology
KW - Analgesics, Opioid/adverse effects
KW - Drug Overdose/drug therapy
KW - Cardiovascular Diseases/epidemiology
U2 - 10.1002/ehf2.14101
DO - 10.1002/ehf2.14101
M3 - SCORING: Journal article
C2 - 35985663
VL - 9
SP - 3973
EP - 3984
JO - ESC HEART FAIL
JF - ESC HEART FAIL
SN - 2055-5822
IS - 6
ER -