The comparison of post OPCABG complications between opium addicted and non- addicted patients

Document Type : original articles

Authors

1 Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 USERN Office, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Objectives: Opium addiction is one of the fundamental public health problems today that could influence cardiovascular disease outcomes. Recent studies have shown that opium addiction may increase the risk of postoperative complications in patients undergoing on-pump coronary artery bypass graft surgery. In this retrospective cross-sectional study, we aimed to assess whether opium addiction may affect the postoperative complications of off-pump coronary artery bypass graft surgery (OPCAB) (1).
Methods: In this cross-sectional study, we searched the clinical records of all patients who underwent OPCAB surgery from 2017/03/21/ to 2018/03/19/ at Afshar and Seyed Al-Shohada Hospitals in Yazd, Iran. We evaluated the patients for postoperative complications. Complete patient demographic and clinical data collected through a review of patient records. Finally, the collected data were analyzed using SPSS software version 18.
Results: A total of 889 patients (667 (76.2%) non-addicted, 127 (14.3%) opium addicts, and 86 (9.6%) smokers and opium addicts) met our criteria and were included in the study. The average age of the participants was 62.09 ± 9.8 years. Frequency distribution of the most postoperative variables such as intubation duration, intensive care unit (ICU) stay, postoperative bleeding volume, pack cell count, need for fresh frozen plasma (FFP), platelet injection volume, need for reoperation, need for intra-aortic balloon pump, as well as Atrial fibrillation (AF) rhythm showed no significant difference between the three groups. However, the only significant difference between the three groups reported the need for postoperative use of inotropic drugs (p=.001).
Conclusions: According to the results, the only complication that differed significantly in the three patient groups after OPCAB was the need for inotropic drugs.

Keywords

References

1.Polomsky M, Puskas JD. Off-pump coronary artery bypass grafting the current state. Circ J. 2012; 76 (4):784-790.
2.D'Agostino RS, Jacobs JP, Badhwar V, et al. The Society of Thoracic Surgeons Adult Cardiac Surgery Database: 2018 Update on Outcomes and Quality. Ann Thorac Surg. 2018;105(1):15-23.
3.Borzou SR, Amiri S, Salavati M, et al. Effects of the First Phase of Cardiac Rehabilitation Training on Self-Efficacy among Patients Undergoing Coronary Artery Bypass Graft Surgery. J Tehran Heart Cent. 2018;13(3):126-131.
4.Bachar BJ, Manna B. Coronary Artery Bypass Graft. InStatPearls [Internet]. StatPearls Publishing.2022.
5.Kasper, D. L., Fauci, A. S., Hauser, S. L., , et al. Harrison’s Principles of Internal Medicine 19/E (Vol. 1 & Vol. 2) (ebook). McGraw Hill Professional. 2015:3000.
6.Diodato M, Chedrawy EG. Coronary artery bypass graft surgery: the past, present, and future of myocardial revascularisation. Surg Res Pract. 2014;2014:726158.
7.Moller CH, Penninga L, Wetterslev J, et al. Off-pump versus on-pump coronary artery bypass grafting for ischaemic heart disease. Cochrane Database Syst Rev.2012(3):CD007224.
8.Yang L, Lin S, Zhang H, et al. Long-Term Graft Patency After Off-Pump and On-Pump Coronary Artery Bypass: A CORONARY Trial Cohort. Ann Thorac Surg. 2020;110(6):2055-2061.
9.Basirat M, Ziyaeifard M, Gorjipour F, et al. Effect of Opium Addiction on Postoperative Arrhythmia Among Patients Undergoing CABG operation on Cardiopulmonary Bypass. Braz J Cardiovasc Surg. 2019;34(4):444-450.
10.Habibi MR, Alipour A, Soleimani A, et al. The effect of opium addiction on short-term postoperative outcomes after coronary artery bypass graft surgery: A prospective observational cohort study. Biomedicine (Taipei). 2020;10(4):23-28.
11.Nemati MH, Astaneh B, Ardekani GS. Effects of opium addiction on bleeding after coronary artery bypass graft surgery: report from Iran. Gen Thorac Cardiovasc Surg. 2010;58(9):456-460.
12.Khademi H, Malekzadeh R, Pourshams A, et al. Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50,000 adults in Iran. BMJ. 2012;344:e2502.
13.Ahmadi J, Toobaee S, Kharras M, et al. Psychiatric disorders in opioid dependants. Int J Soc Psychiatry. 2003;49(3):185-191.
14.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.
15.Zardosht R, Hashemian M, Moghaddamhosseini V, et al. Substance use among non-fatally injured patients attended emergency departments in North-East of Iran; Sabzevar. Life Sci. 2012.
16.Zarghami M. Iranian Common Attitude Toward Opium Consumption. Iran J Psychiatry Behav Sci. 2015;9(2):e2074.
17.Abdollahi M, Zahreh S. Demografic characteristics of opioid addiction in patients undergoing Coronary Artery Bypass Graft. Tehran Univ Med J. 2006;64(10):54-59.
18.Azarasa M, Azarfarin R, Changizi A, et al. Substance use among Iranian cardiac surgery patients and its effects on short-term outcome. Anesth Analg. 2009;109(5):1553-1559.
19.Sabzi F, Zokaei AH, Moloudi AR. Predictors of atrial fibrillation following coronary artery bypass grafting. Clin Med Insights Cardiol. 2011;5:67-75.
20.Sadeghian S, Karimi A, Dowlatshahi S, 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(6):365-372.
21.Safaii N, Kazemi B. Effect of opium use on short-term outcome in patients undergoing coronary artery bypass surgery. Gen Thorac Cardiovasc Surg. 2010;58(2):62-67.
22.Montrief T, Koyfman A, Long B. Coronary artery bypass graft surgery complications: A review for emergency clinicians. Am J Emerg Med. 2018;36(12):2289-2297.
23.Saunders JB. Substance use and addictive disorders in DSM-5 and ICD 10 and the draft ICD 11. Curr Opin Psychiatry. 2017;30(4):227-237.
24.Mokri A. Brief overview of the status of drug abuse in Iran. Arch Iran Med. 2002;5(3):184-190.
25.Rahimimovaghar A, Razzagi E, Khajavi M. Guideline for prevention and treatment of addiction. Tehran: Prevention of Vice Cultural Welfare Organization.1997.
26.Masoomi M, Ramezani MA, Karimzadeh H. The relationship of opium addiction with coronary artery disease. Int J Prev Med. 2010;1(3):182-186.
27.Sanderson K, Nyberg F, Khalil Z. Modulation of peripheral inflammation by locally administered hemorphin-7. Inflamm Res. 1998;47(2):49-55.
28.Członkowski A, Stein C, Herz A. Peripheral mechanisms of opioid antinociception in inflammation: involvement of cytokines. Eur J Pharmacol. 1993;242(3):229-235.
29.Marmor M, Penn A, Widmer K, et al. Coronary artery disease and opioid use. Am J Cardiol. 2004;93(10):1295-1297.
30.Sadeghian S, Graili P, Salarifar M, et al. 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(1):116-118.
31.Mohammadi A, Darabi M, Nasry M, et al. Effect of opium addiction on lipid profile and atherosclerosis formation in hypercholesterolemic rabbits. Exp Toxicol Pathol. 2009;61(2):145-149.
32.Najafi M, Jahangiry L, Mortazavi SH, et al. Outcomes and long-term survival of coronary artery surgery: The controversial role of opium as risk marker. World J Cardiol. 2016;8(11):676-683.
33.Farhangi MA, Moradi F, Najafi M, et al. 10-year survival in coronary artery bypass grafting surgery patients in Tehran heart center, coronary outcome measurement study: Predictive power of dietary inflammatory index and dietary antioxidant quality. Nutrition. 2019;63-64:22-28.
34.Basirat M, Ziyaeifard M, Gorjipour F, et al. Effect of Opium Addiction on Postoperative Arrhythmia Among Patients Undergoing CABG operation on Cardiopulmonary Bypass. Braz J Cardiovasc Surg. 2019;34(4):444-450.
35.Mujović N, Marinković M, Mihajlović M, et al. Risk factor modification for the primary and secondary prevention of atrial fibrillation. Part 1. Kardiol Pol. 2020;78(3):181-191.
Cardiovascular Biomedicine
Volume 2, Issue 2
December 2022
Pages 25-30

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History

  • Receive Date: 04 November 2021
  • Revise Date: 16 February 2023
  • Accept Date: 05 March 2023
  • First Publish Date: 05 March 2023

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