Does analgesic effect of opium hamper the adverse effects of severe coronary artery disease on quality of life in addicted patients?

Abstract

Background: Opium is a unique substance, regarding its analgesic effects. This may change the deteriorating effects of coronary artery disease (CAD) on quality of life (QOL) in addicted patients. Objectives: We studied the QOL in opium-addicted and non-addicted CAD patients so as to determine the relationship between CAD risk factors and the subscales of their QOL. Patients and Methods: Demographic and laboratory data as well as coronary artery risk factors were obtained and SF-36 questionnaire was completed through interviews with 268 (38 opium-addicted and 230 non-addicted) patients with CAD who were candidates for isolated coronary artery bypass at Tehran Heart Center. Results: Mean Euro SCORE in addicted and non-addicted patients were 3.7 ± 7.6 and 2.4 ± 2.2 respectively (P = 0.036). In addicted group, higher preoperative HbA1c was associated with low physical function score (β = -0.395, P = 0.021). Low ejection fraction could negatively affect the general health (β = 0.394, P = 0.014) and mental health (β = 0.292, P = 0.015) subscales in the addicted group. Conclusions: Despite higher rate of morbidities in opium-addicted patients compared to non-addicted ones, subscales of QOL were similar between the two groups. High preoperative HbA1c and low ejection fraction appeared to be determinants of poor QOL in the opium-addicted patients. © 2012 Iranian Society of Regional Anesthesia and Pain Medicine.