Tuesday, August 24, 2021

Study highlights steep rise in cardiac

arrests associated with opioid use

EUROPEAN SOCIETY OF CARDIOLOGY

Sophia Antipolis, France – 23 Aug 2021: A nationwide US study has shown that the rate of opioid-related cardiac arrests has steeply risen and is now on par with the rate of cardiac arrest from other causes. The research is presented at ESC Congress 2021.1

Opioid use disorder, which includes dependence and addiction, affects more than two million people in the US, while opioid overdose is the leading cause of death for those aged 25 to 64 years.2

This study examined the trends and outcomes of opioid-related cardiac arrest in 2012 to 2018. The US Nationwide Readmissions Database (NRD) was used to study all hospitalisations for cardiac arrest in active or chronic opioid users compared to cardiac arrests in patients not using opioids.

Of 1,410,475 cardiac arrest hospitalisations, 43,090 (3.1%) occurred in opioid users. The rate of in-hospital mortality in cardiac arrest patients with and without opioid use was 56.7% versus 61.2%, respectively. However, in an analysis adjusted for several factors including liver disease, atrial fibrillation and renal failure, there was no difference in the risk of mortality between cardiac arrest patients with or without opioid abuse (odds ratio 0.96; 95% confidence interval 0.92–1.01; p=0.15). Opioid users had higher rates of alcohol abuse (16.9% vs. 7.1%; p<0.05), depression (18.8% vs. 9%; p<0.05) and smoking (37.0% vs. 21.8%; p<0.05) compared to those not using opioids.

The study found a significant increasing trend in opioid-associated cardiac arrest over the seven-year period (p for trend <0.05).

Study author Ms. Senada S. Malik, a medical researcher at the University of New England, Biddeford, US said: “The rise in opioid-related cardiac arrests during the study period was significant. By 2018, opioids were related to a similar number of cardiac arrests as all other reasons put together.”

She continued: “This was an observational study so we cannot conclude causality, but the findings do suggest that the opioid epidemic in the US may have contributed to an increasing number of cardiac arrests.”

Ms. Malik concluded: “The rising use of opioids is having a devastating impact on the lives of many Americans. Abuse of these drugs has been linked with poor lifestyle choices including excessive alcohol intake, lack of exercise, insufficient sleep and smoking – which can lead to a downward spiral of poor decision-making. A constant need for opioids contributes to addiction, depression, poverty, unemployment and criminal/legal problems. Public health strategies including increased surveillance, research, and tracking opioid cases are desperately needed to curtail this epidemic.”

ENDS

Notes to editors

Authors: ESC Press Office

Mobile: +33 (0)7 85 31 20 36
Email: press@escardio.org

The hashtag for ESC Congress 2021 is #ESCCongress.

Funding: None.

Disclosures: None.

References and notes

1Abstract title: Trends and outcomes in opioid related cardiac arrest in a contemporary US population from 2012-18.

2Dezfulian C, Orkin AM, Maron BA, et al. Opioid-associated out-of-hospital cardiac arrest: Distinctive clinical features and implications for health care and public responses. Circulation. 2021;143:e836–e870.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2021 - The Digital Experience

It is the world’s largest gathering of cardiovascular professionals, disseminating ground-breaking science in a new digital format. Online each day – from 27 to 30 August. Explore the scientific programme. More information is available from the ESC Press Office at press@escardio.org.

Heart attacks in young adults are related to unhealthy lifestyles, not just family history

Reports and Proceedings

EUROPEAN SOCIETY OF CARDIOLOGY

Sophia Antipolis, France – 24 Aug 2021: Young heart attack victims are more likely to be smokers, obese, and have high blood pressure or diabetes compared to their peers, according to research presented at ESC Congress 2021.1 The study shows that while parental history of a premature heart attack is linked with heart events at a young age, it is not the only contributing factor.

“The findings underline the importance of preventing smoking and overweight in children and adolescents in order to reduce the likelihood of heart disease later in life,” said study author Professor Harm Wienbergen of the Bremen Institute for Heart and Circulation Research, Germany.

“Understanding the reasons for heart attacks in young adults is important from a societal perspective due to their employment and family responsibilities,” he continued. “However, there are limited data on the predictors of heart events in this group.”

The case-control study compared the clinical characteristics of consecutive patients admitted to hospital with acute myocardial infarction at 45 years of age or younger with randomly selected individuals from the general population in the same geographic region in Germany. Cases and controls were matched according to age and gender.

A total of 522 patients were enrolled from the Bremen STEMI registry and 1,191 matched controls were identified from the German National Cohort (NAKO).

The proportion of active smokers was more than three-fold higher in the young heart attack group compared to the general population (82.4% vs. 24.1%; p<0.01). Patients were more likely to have high blood pressure (25.1% vs. 0.5%; p<0.01), diabetes (11.7% vs. 1.7%; p<0.01) and a parental history of premature heart attack (27.6% vs. 8.1%; p<0.01) compared to their peers. Patients were more often obese, with a median body mass index (BMI) of 28.4 kg/m2 compared to 25.5 kg/m2 for controls (p<0.01). In contrast, the proportion consuming alcohol at least four times a week was higher in the general population (11.2%) compared to heart patients (7.1%; p<0.01).

The researchers analysed the independent risk factors for the occurrence of acute myocardial infarction at 45 years of age or younger. The analysis was adjusted for age, sex, high blood pressure, diabetes, active smoking, body mass index, alcohol consumption, years of school education, and birth in Germany.

Having hypertension was associated with an 85-fold odds of a heart attack aged 45 or under. The corresponding odds of a premature heart attack associated with active smoking, diabetes mellitus, parental history and obesity (BMI 30 kg/m2 or above) were 12, 5, 3 and 2. Alcohol consumption was associated with a lower odds of heart attack at a young age with an odds ratio of 0.3.

Professor Wienbergen said: “Our study shows that smoking and metabolic factors, such as hypertension, diabetes and obesity, are strongly associated with an increased likelihood of premature acute myocardial infarction. A protective effect of moderate alcohol consumption has been described by other studies2 and is confirmed in the present analysis of young patients.”

He concluded: “Our study suggests that family history is not the only predisposing factor for early heart attacks. The findings add impetus to the argument that young people should be educated about why it is important to avoid smoking and have a healthy body weight.”

ENDS

Notes to editors

Authors: ESC Press Office
Mobile: +33 (0)7 85 31 20 36
Email: press@escardio.org

The hashtag for ESC Congress 2021 is #ESCCongress.

This press release accompanies an abstract at ESC Congress 2021. It does not necessarily reflect the opinion of the European Society of Cardiology.

Funding: The Bremen STEMI registry is funded by the Gesundheit Nord – Klinikverbund Bremen and the Stiftung Bremer Herzen. The German National Cohort is funded by the Federal Ministry of Education and Research (BMBF), federal states, and the Helmholtz Association, with additional financial support from the participating universities and the institutes of the Leibniz Association.

Disclosures: There are no conflicts of interest to disclose.

References and notes

1Abstract title: Risk factors in young patients with myocardial infarction: what is different from the general population?

2Leong DP, Smyth A, Teo KK, et al. Patterns of alcohol consumption and myocardial infarction risk. Circulation. 2014;130:390–398.