Department of Cardiology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Objective: Coronary artery disease is one of the leading causes of morbidity and mortality in populations. In opium abusers, level of circulating coagulation factors differs from nonabusers. The aim of this study was to evaluate response to thrombolytic therapy in opium abusers vs. non-abusers. Methods: In this prospective observational study, 83 patients (36 opium abusers and 47 nonabusers) with AMI were evaluated for the presence and degree of response to thrombolytic agent. All patients were monitored for electrocardiographic changes and response to thrombolysis 2 hours before and after administration of thrombolytic agent. Serum CPK and LDH were measured 2 hours before and after thrombolysis. Quantitative and qualitative data were analyzed by independent t-test and chi-square using SPSS, respectively. Findings: ST-resolution 2 hours after thrombolysis was 63.8% and 44.4% in opium users and non-users, respectively. Serum level of CPK cardiac biomarker 2 hours after thrombolysis was 980 ± 245 and 847 ± 130 IU/L in opium users and non-users, respectively. Conclusion: Our data demonstrate that in those patients with opium abuse, electrocardiographic changes after thrombolysis were significantly lower than opium nonusers (P < 0.05). Opium users showed better ST-resolution compared with non-users. Opium addiction had effect on cardiac enzymes despite their effect on response to streptokinase.
Joukar S, Najafipour H, Malekpour-Afshar R, Mirzaeipour F, Nasri HR. The effect of passive opium smoking on cardiovascular indices of rabbits with normal and ischemic hearts. Open Cardiovasc Med J 2010;4:1-6. 2. Masoumi M, Shahesmaeili A, Mirzazadeh A, Tavakoli M, Ali AZ. Opium addiction and severity of coronary artery disease: A case-control study. J Res Med Sci 2010;15:27-32. 3. Asgary S, Sarrafzadegan N, Naderi GA, Rozbehani R. Effect of opium addiction on new and traditional cardiovascular risk factors: do duration of addiction and route of administration matter? Lipids Health Dis 2008;7:42. 4. Sadr BSM, Rafiei M, Bahadorzadeh L, Namayandeh SM, Soltani MH, Motafaker M, et al. Is opium addiction a risk factor for acute myocardial infarction? Acta Med Iran 2005;43:218-22.
5. Davoodi G, Sadeghian S, Akhondzadeh S, Darvish S, Alidoosti M, Amirzadegan A. Comparison of specifications, short term outcome and prognosis of acute myocardial infarction in opium dependent patients and nondependents. J Tehran Heart Center 2006;1:43-7. 6. Azimzade-Sarwar B, Gholamreza YG, Narooey S. A casecontrol study of effect of opium addiction on myocardial infarction. Am J Appl Sci 2005;2:1134-5. 7. Yavuz S. Surgery as early revascularization after acute myocardial infarction. Anadolu Kardiyol Derg 2008;8 Suppl 2:84-92. 8. Peart JN, Gross ER, Gross GJ. Opioid-induced preconditioning: recent advances and future perspectives. Vascul Pharmacol 2005;42:211-8. 9. Schultz J, Hsu AK, Nagase H, Gross GJ. TAN-67, a delta 1-opioid receptor agonist, reduces infarct size via activation of Gi/o proteins and KATP channels. Am J Physiol 1998;274:H909-14. 10. Schultz JJ, Hsu AK, Gross GJ. Ischemic preconditioning and morphine-induced cardioprotection involve the delta (delta)- opioid receptor in the intact rat heart. J Mol Cell Cardiol 1997;29:2187-95. 11. Masoomi M, Ghaemi F, Haghdost A, Rashidinejad H. ST segment resolution in opium addiction patients after thrombolytic therapy for acute myocardial infarction. ARYA Atheroscler 2008;4:103-7. 12. Azimzade-Sarwar B, Yousefzade Gh, Narooey Sh. A casecontrol study of effect of opium addiction on myocardial infarction. Am J Appl Sci 2005;2:1134-5. 13. Lu Y, Dong CS, Yu JM, Li H. Morphine Reduces the Threshold of Remote Ischemic Preconditioning Against Myocardial Ischemia and Reperfusion Injury in Rats: The Role of Opioid Receptors. J Cardiothorac Vasc Anesth 2012;26:403-6. 14. Lu Y, Dong C, Yu J, Li L. Role of central and peripheral opioid receptors in the cardioprotection of intravenous morphine preconditioning. Ir J Med Sci 2011;180:881-5.
Seyed Mohammad Hashemi Jazi,.. , Idin Ahang Nazary,.. and Mohaddeseh Behjati,.. (2012). Response to thrombolytic agents in acute myocardial infarction in opium abusers versus non-abusers. Journal of Research in Pharmacy Practice, 1(1), 34-36.
MLA
Seyed Mohammad Hashemi Jazi,.. , , Idin Ahang Nazary,.. , and Mohaddeseh Behjati,.. . "Response to thrombolytic agents in acute myocardial infarction in opium abusers versus non-abusers", Journal of Research in Pharmacy Practice, 1, 1, 2012, 34-36.
HARVARD
Seyed Mohammad Hashemi Jazi .., Idin Ahang Nazary .., Mohaddeseh Behjati .. (2012). 'Response to thrombolytic agents in acute myocardial infarction in opium abusers versus non-abusers', Journal of Research in Pharmacy Practice, 1(1), pp. 34-36.
CHICAGO
.. Seyed Mohammad Hashemi Jazi, .. Idin Ahang Nazary and .. Mohaddeseh Behjati, "Response to thrombolytic agents in acute myocardial infarction in opium abusers versus non-abusers," Journal of Research in Pharmacy Practice, 1 1 (2012): 34-36,
VANCOUVER
Seyed Mohammad Hashemi Jazi .., Idin Ahang Nazary .., Mohaddeseh Behjati .. Response to thrombolytic agents in acute myocardial infarction in opium abusers versus non-abusers. Journal of Research in Pharmacy Practice, 2012; 1(1): 34-36.