Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study

Abstract

A bstract Background Toxicity and side effects of long-term use of opioids are well studied, but little information exists regarding electrophysiological disturbances of opium consumption. While natural opium has been regarded safe to a great extent among traditional communities, concerns are emerging owing to the available evidence of QT prolongation that have been exposed during recent outcome surveillance of patients under opioid use. Potential QT prolonging interactions would raise a higher level of such concern in opium users during COVID pandemic and warrant attention. Materials and methods This study was designed to detect the prevalence of QTc prolongation among opium users and nonusers. Two groups were compared with regard to gender, age, and median QTc interval. Normal and prolonged QTc intervals of user group were compared with respect to age, sex, dose of opium consumption, and duration of opium consumption. Results 123 opium users and 39 controls were investigated. Median QTc interval in opium user and non-user group was 460 vs 386 milliseconds, respectively ( p value < 0.001). In all, 59.3%, (95% CI: 50.51–67.62%) of cases and none of non-user had prolonged QTc interval ( p value < 0.001). There was no significance between normal and prolonged QTc intervals with respect to dose and duration of opium use. Conclusion This study indicated that opium consumption is associated with QTc prolongation. This prolongation does not relate to dose and duration of opium use. Further study is propounded to assess the clinical significance of these results and to determine risk rating of opium compared to other opioids in this regard. How to cite this article Javadi HR, Mirakbari SM, Allami A, Yazdi Z, Katebi K. Opium-associated QT Interval Prolongation: A Cross-sectional Comparative Study. Indian J Crit Care Med 2021;25(1):43–47.

Prevalence and factors associated with electrocardiographic abnormalities among adults attending Methadone Assisted Therapy in Dodoma, central Tanzania

“…A 61% prevalence was reported in Austria(21). Martell et al, reported a prevalence of 48.3% among 118 patients with opioid use disorder on methadone treatment (22), a prevalence of 54% in the United States of America(23), and 59.3% in India(24). The variations in the study population may explain the diversity in prevalence.…”

“…The variations in the study population may explain the diversity in prevalence. In contrast, this study had younger; a study in India included opioid users who were older and with comorbid non-cardiac medical conditions(24).…”

“…A month increase in duration on MAT was also found to be significantly associated with sinus bradycardia (AOR = 0.74, 95% CI = 0.63-0.87, p = 0.001) (Table 6). (22), a prevalence of 54% in the United States of America (23), and 59.3% in India (24). The variations in the study population may explain the diversity in prevalence.…”

Increasing opium use in Iran in response to unsubstantiated rumors that it protects against COVID‐19

“…So, what is the reason for an increased mortality rate from COVID‐19 among individuals who use opium? According to a critical review of recent literature on short‐term effects of opium consumption, there are five main relevant reasons: (i) down‐regulation of anti‐viral cytokine expression such as interferon (IFN)‐α and IFN‐γ; (ii) development of pulmonary edema following endothelial dysfunction; (iii) increase thrombotic factors such as plasma fibrinogen and plasminogen activator inhibitor 1; (iv) increase ACE‐2 via stimulating silent information regulator 1 expression; (v) increased risk of pneumonia due to their effect on the medullary respiratory centers and decreased ventilation; and (vi) QT interval prolongation [ 7 , 8 , 9 ].…”