Opium Addiction and Coagulation Factors in ST-Segment Elevation Myocardial Infarction (STEMI) Patients: Implications for Thrombosis and Cardiovascular Outcomes
-
Nahid Azdaki
,
Seyed Ali Moezi Bady
,
Tooba Kazemi
,
Mahsa Najafzadeh
,
Amin Golestani
,
Ahmad Moradi-Poodeh
,
Hanieh Dadaei-Joushgheani
,
Seyed Mehdi Sajjadi
Abstract
Background: Myocardial infarction (MI) is one of the most common causes of death globally. Since a comprehensive study on the relationship between coagulation factors in AMI patients and opium consumption has not been done, in this study the effect of opium consumption on the number of coagulation factors I, II, VII, IX, and XI in patients with myocardial infarction and ST-elevated (STEMI) was investigated. Furthermore, our results shed light on the relationship between opium and coagulation factors with thrombosis grades.
Methods: In this case-control study, 80 STEMI patients referred to Razi Birjand Hospital, Iran, between years 2021 to 2022 were divided into two groups of opium addicts and non-addicts based on opium consumption and non-addict use, and the levels of the mentioned coagulation factors in their plasma were measured and compared with the corresponding values in 80 healthy people. Collected data was analyzed using SPSS software. The significance level of all tests was 5%.
Results: The number of coagulation factors I, II, VII, and IX, unlike factor XI, in the opium addict group was significantly higher than the other two groups. While there was no statistically significant relationship between these coagulation factors with different degrees of thrombosis, most of the studied population were classified as Grade 5. Results also suggest no significant correlation between biochemical parameters and opium consumption.
Conclusion: Opium consumption can cause thrombosis by increasing the level of some coagulation factors. The findings from this study could have implications for clinical practice and public health interventions related to opium addiction and its impact on cardiovascular outcomes.
1. Maino A, Rosendaal FR, Algra A, et al (2015). Hypercoagulability is a stronger risk factor for ischaemic stroke than for myocardial infarction: a systematic review. PLoS One, 10 (8): e0133523.
2. Siegerink B, Rosendaal F, Algra A (2014). Antigen levels of coagulation factor XII, coagulation factor XI and prekallikrein, and the risk of myocardial infarction and ischemic stroke in young women. J Thromb Haemost, 12 (5): 606-13.
3. Siegerink B, Maino A, Algra A, et al (2015). Hypercoagulability and the risk of myocardial infarction and ischemic stroke in young women. J Thromb Haemost, 13 (9): 1568-75.
4. Golestani A, Rahimi A, Moezi Bady SA, et al (2024). Src homology 2-B adapter protein 3 C784 T and Methylenetetrahydrofolate reductase C677 T Polymorphisms and Inflammation Markers in ST-segment Elevation Myocardial Infarction Patients. Angiology, 75(3):281-287.
5. Stevens SM, Woller SC, Bauer KA, et al (2016). Guidance for the evaluation and treatment of hereditary and acquired thrombophilia. J Thromb Thrombolysis, 41: 154-64.
6. Amin‐Esmaeili M, Rahimi‐Movaghar A, Sharifi V, et al (2016). Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey. Addiction, 111 (10): 1836-47.
7. Roshanpajouh M, Mirkazemi R, Ehterami M, et al (2020). Drug use among Iranian population: results of a national household survey. J Substance Use, 25 (2): 146-51.
8. Azdaki N, Zardast M, Anani-Sarab G, et al (2017). Comparison between homocysteine, fibrinogen, PT, PTT, INR and CRP in male smokers with/without addiction to opium. Addict Health, 9 (1): 17-23.
9. Momtazi S, Rawson RA (2010). Substance abuse among Iranian high school students. Curr Opin Psychiatry, 23 (3): 221-6.
10. Noorbala AA, Saljoughian A, Yazdi SAB, et al (2020). Evaluation of drug and alcohol abuse in people aged 15 years and older in Iran. Iran J Public Health, 49 (10): 1940-1946.
11. Davoodi G, Sadeghian S, Akhondzadeh S, et al (2006). Comparison of specifications, short term outcome and prognosis of acute myocardial infarction in opium dependent patients and nondependents. J Tehran Univ Heart Cent, 1 (1): 48-53.
12. Nakhaee N, Ziaaddini H, Karimzadeh A (2009). Epidemiologic study on drug abuse among first and second grade high school students in Kerman. Addict Health, 1(1): 31-6.
13. Najafipour H, Masoumi M, Amirzadeh R, et al (2022). Trends in the Prevalence and Incidence of Opium Abuse and its Association with Coronary Artery Risk Factors in Adult Population in Iran: Findings from Kerman Coronary Artery Disease Risk Factors Study. Iran J Med Sci, 47 (4): 328-337.
14. Masoudkabir F, Sarrafzadegan N, Eisenberg MJ (2013). Effects of opium consumption on cardiometabolic diseases. Nat Rev Cardiol, 10 (12): 733-40.
15. Khademi H, Malekzadeh R, Pourshams A, et al (2012). Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50000 adults in Iran. BMJ, 344: e2502.
16. Mousavi M, Kalhor S, Alizadeh M, et al (2021). Opium addiction and correlation with early and six-month outcomes of presenting with ST elevation myocardial infarction treated initially with thrombolytic therapy. Am J Cardiovasc Dis, 11 (1): 115-123.
17. Nakhaee S, Ghasemi S, Karimzadeh K, et al (2020). The effects of opium on the cardiovascular system: a review of side effects, uses, and potential mechanisms. Subst Abuse Treat Prev Policy, 15 (1): 30.
18. Rallidis LS, Gialeraki A, Tsirebolos G, et al (2017). Prothrombotic genetic risk factors in patients with very early ST-segment elevation myocardial infarction. J Thromb Thrombolysis, 44: 267-73.
19. Schultz JEJ, Gross GJ (2001). Opioids and cardioprotection. Pharmacol Ther, 89 (2): 123-37.
20. Naderi G, Asgary S, Sadeghi M, et al (2005). Comparing plasma level of CRP, factor VII, fibrinogen; platelet counts, systolic and diastolic blood pressure in smokers with opium addicted smokers. J Qazvin Univ Med Sci, 9(2):3-7.
21. Campo G, Pavasini R, Pollina A, et al (2012). Thrombin generation assay: a new tool to predict and optimize clinical outcome in cardiovascular patients? Blood Coagul Fibrinolysis, 23 (8): 680-7.
22. Ye Z, Liu EH, Higgins JP, et al (2006). Seven haemostatic gene polymorphisms in coronary disease: meta-analysis of 66 155 cases and 91 307 controls. Lancet, 367 (9511): 651-8.
23. Merzaeipoor F, Azdaki N, Mohamadi G, et al (2013). The effects of opium addiction through different administration routes on inflammatory and coagulation factors. J Kerman Univ Med Sci, 20 (3): 292-300.
24. Masoudkabir F, Malekzadeh R, Yavari N, et al (2022). Does opium consumption have shared impact on atherosclerotic cardiovascular disease and cancer? Arch Iran Med, 25 (1): 50-63.
25. Carew J, Basso F, Miller G, et al (2003). A functional haplotype in the 5′ flanking region of the factor VII gene is associated with an increased risk of coronary heart disease. J Thromb Haemost, 1 (10): 2179-85.
26. Girelli D, Russo C, Ferraresi P, et al (2000). Polymorphisms in the factor VII gene and the risk of myocardial infarction in patients with coronary artery disease. N Engl J Med, 343 (11): 774-80.
27. Iacoviello L, Di Castelnuovo A, de Knijff P, et al (1998). Polymorphisms in the coagulation factor VII gene and the risk of myocardial infarction. N Engl J Med, 338 (2): 79-85.
28. Campo G, Valgimigli M, Ferraresi P, et al (2006). Tissue factor and coagulation factor VII levels during acute myocardial infarction: association with genotype and adverse events. Arterioscler Thromb Vasc Biol, 26 (12): 2800-6.
29. Asgary S, Sarrafzadegan N, Naderi G-A, et al (2008). Effect of opium addiction on new and traditional cardiovascular risk factors: do duration of addiction and route of administration matter? Lipids Health Dis, 7 :42.
30. Mousavi-Mirzaei SM, Talebi A, Amirabadizadeh A, et al ( 2019). Increasing the risk of stroke by opium addiction. J Stroke Cerebrovasc Dis, 28 (7): 1930-5.
31. Moqaddam AH, Musavi SMRA, Khademizadeh K (2009). Relationship of opium dependency and stroke. Addict Health, 1 (1): 6-10.
32. Li Y, Bezemer I, Rowland C, et al (2009). Genetic variants associated with deep vein thrombosis: the F11 locus. J Thromb Haemost, 7 (11): 1802-8.
33. Butenas S, Undas A, Gissel MT, et al (2008). Factor XIa and tissue factor activity in patients with coronary artery disease. Thromb Haemost, 99 (1): 142-9.
34. Undas A, Slowik A, Gissel M, et al (2011). Circulating activated factor XI and active tissue factor as predictors of worse prognosis in patients following ischemic cerebrovascular events. Thromb Res, 128 (5): e62-6.
35. Minnema M, Peters R, De Winter R, et al (2000). Activation of clotting factors XI and IX in patients with acute myocardial infarction. Arterioscler Thromb Vasc Biol, 20 (11): 2489-93.
36. Salomon O, Steinberg D, Dardik R, et al (2003). Inherited factor XI deficiency confers no protection against acute myocardial infarction. J Thromb Haemost, 1 (4): 658-61.
37. Chougule A, Rajpal S, Ahluwalia J, et al (2016). Coagulation factor VIII, IX and XI levels in north Indian patients with venous thromboembolism: first study from India. Blood Coagul Fibrinolysis, 27 (1): 58-63.
38. Del Portillo JH, Echeverri D, Cabrales J (2019). Association of the use of manual thrombus aspiration with intracoronary thrombotic burden in patients with ST segment elevation myocardial infarction in the real world. Int J Cardiol Heart Vasc, 26: 100436.
39. Wang H, Rosendaal FR, Cushman M, et al (2021). Procoagulant factor levels and risk of venous thrombosis in the elderly. J Thromb Haemost, 19 (1): 186-193.
40. Rostamzadeh A, Khademvatani K (2016). Comparison of myocardial infarction outcome in opium dependent and non-dependent patients. Studies Med Sci, 27 (3): 208-14.
41. Aghadavoudi O, Eizadi-Mood N, Najarzadegan MR (2015). Comparing cardiovascular factors in opium abusers and non-users candidate for coronary artery bypass graft surgery. Adv Biomed Res, 4:12.
42. Hoseini SS, Saadatjoo SA, Nakhaee S, et al (2019). Potential effect of opium addiction on lipid profile and blood glucose concentration in type 2 diabetic patients in Iran. J Subst Use, 24 (4): 420-5.
2. Siegerink B, Rosendaal F, Algra A (2014). Antigen levels of coagulation factor XII, coagulation factor XI and prekallikrein, and the risk of myocardial infarction and ischemic stroke in young women. J Thromb Haemost, 12 (5): 606-13.
3. Siegerink B, Maino A, Algra A, et al (2015). Hypercoagulability and the risk of myocardial infarction and ischemic stroke in young women. J Thromb Haemost, 13 (9): 1568-75.
4. Golestani A, Rahimi A, Moezi Bady SA, et al (2024). Src homology 2-B adapter protein 3 C784 T and Methylenetetrahydrofolate reductase C677 T Polymorphisms and Inflammation Markers in ST-segment Elevation Myocardial Infarction Patients. Angiology, 75(3):281-287.
5. Stevens SM, Woller SC, Bauer KA, et al (2016). Guidance for the evaluation and treatment of hereditary and acquired thrombophilia. J Thromb Thrombolysis, 41: 154-64.
6. Amin‐Esmaeili M, Rahimi‐Movaghar A, Sharifi V, et al (2016). Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey. Addiction, 111 (10): 1836-47.
7. Roshanpajouh M, Mirkazemi R, Ehterami M, et al (2020). Drug use among Iranian population: results of a national household survey. J Substance Use, 25 (2): 146-51.
8. Azdaki N, Zardast M, Anani-Sarab G, et al (2017). Comparison between homocysteine, fibrinogen, PT, PTT, INR and CRP in male smokers with/without addiction to opium. Addict Health, 9 (1): 17-23.
9. Momtazi S, Rawson RA (2010). Substance abuse among Iranian high school students. Curr Opin Psychiatry, 23 (3): 221-6.
10. Noorbala AA, Saljoughian A, Yazdi SAB, et al (2020). Evaluation of drug and alcohol abuse in people aged 15 years and older in Iran. Iran J Public Health, 49 (10): 1940-1946.
11. Davoodi G, Sadeghian S, Akhondzadeh S, et al (2006). Comparison of specifications, short term outcome and prognosis of acute myocardial infarction in opium dependent patients and nondependents. J Tehran Univ Heart Cent, 1 (1): 48-53.
12. Nakhaee N, Ziaaddini H, Karimzadeh A (2009). Epidemiologic study on drug abuse among first and second grade high school students in Kerman. Addict Health, 1(1): 31-6.
13. Najafipour H, Masoumi M, Amirzadeh R, et al (2022). Trends in the Prevalence and Incidence of Opium Abuse and its Association with Coronary Artery Risk Factors in Adult Population in Iran: Findings from Kerman Coronary Artery Disease Risk Factors Study. Iran J Med Sci, 47 (4): 328-337.
14. Masoudkabir F, Sarrafzadegan N, Eisenberg MJ (2013). Effects of opium consumption on cardiometabolic diseases. Nat Rev Cardiol, 10 (12): 733-40.
15. Khademi H, Malekzadeh R, Pourshams A, et al (2012). Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50000 adults in Iran. BMJ, 344: e2502.
16. Mousavi M, Kalhor S, Alizadeh M, et al (2021). Opium addiction and correlation with early and six-month outcomes of presenting with ST elevation myocardial infarction treated initially with thrombolytic therapy. Am J Cardiovasc Dis, 11 (1): 115-123.
17. Nakhaee S, Ghasemi S, Karimzadeh K, et al (2020). The effects of opium on the cardiovascular system: a review of side effects, uses, and potential mechanisms. Subst Abuse Treat Prev Policy, 15 (1): 30.
18. Rallidis LS, Gialeraki A, Tsirebolos G, et al (2017). Prothrombotic genetic risk factors in patients with very early ST-segment elevation myocardial infarction. J Thromb Thrombolysis, 44: 267-73.
19. Schultz JEJ, Gross GJ (2001). Opioids and cardioprotection. Pharmacol Ther, 89 (2): 123-37.
20. Naderi G, Asgary S, Sadeghi M, et al (2005). Comparing plasma level of CRP, factor VII, fibrinogen; platelet counts, systolic and diastolic blood pressure in smokers with opium addicted smokers. J Qazvin Univ Med Sci, 9(2):3-7.
21. Campo G, Pavasini R, Pollina A, et al (2012). Thrombin generation assay: a new tool to predict and optimize clinical outcome in cardiovascular patients? Blood Coagul Fibrinolysis, 23 (8): 680-7.
22. Ye Z, Liu EH, Higgins JP, et al (2006). Seven haemostatic gene polymorphisms in coronary disease: meta-analysis of 66 155 cases and 91 307 controls. Lancet, 367 (9511): 651-8.
23. Merzaeipoor F, Azdaki N, Mohamadi G, et al (2013). The effects of opium addiction through different administration routes on inflammatory and coagulation factors. J Kerman Univ Med Sci, 20 (3): 292-300.
24. Masoudkabir F, Malekzadeh R, Yavari N, et al (2022). Does opium consumption have shared impact on atherosclerotic cardiovascular disease and cancer? Arch Iran Med, 25 (1): 50-63.
25. Carew J, Basso F, Miller G, et al (2003). A functional haplotype in the 5′ flanking region of the factor VII gene is associated with an increased risk of coronary heart disease. J Thromb Haemost, 1 (10): 2179-85.
26. Girelli D, Russo C, Ferraresi P, et al (2000). Polymorphisms in the factor VII gene and the risk of myocardial infarction in patients with coronary artery disease. N Engl J Med, 343 (11): 774-80.
27. Iacoviello L, Di Castelnuovo A, de Knijff P, et al (1998). Polymorphisms in the coagulation factor VII gene and the risk of myocardial infarction. N Engl J Med, 338 (2): 79-85.
28. Campo G, Valgimigli M, Ferraresi P, et al (2006). Tissue factor and coagulation factor VII levels during acute myocardial infarction: association with genotype and adverse events. Arterioscler Thromb Vasc Biol, 26 (12): 2800-6.
29. Asgary S, Sarrafzadegan N, Naderi G-A, et al (2008). Effect of opium addiction on new and traditional cardiovascular risk factors: do duration of addiction and route of administration matter? Lipids Health Dis, 7 :42.
30. Mousavi-Mirzaei SM, Talebi A, Amirabadizadeh A, et al ( 2019). Increasing the risk of stroke by opium addiction. J Stroke Cerebrovasc Dis, 28 (7): 1930-5.
31. Moqaddam AH, Musavi SMRA, Khademizadeh K (2009). Relationship of opium dependency and stroke. Addict Health, 1 (1): 6-10.
32. Li Y, Bezemer I, Rowland C, et al (2009). Genetic variants associated with deep vein thrombosis: the F11 locus. J Thromb Haemost, 7 (11): 1802-8.
33. Butenas S, Undas A, Gissel MT, et al (2008). Factor XIa and tissue factor activity in patients with coronary artery disease. Thromb Haemost, 99 (1): 142-9.
34. Undas A, Slowik A, Gissel M, et al (2011). Circulating activated factor XI and active tissue factor as predictors of worse prognosis in patients following ischemic cerebrovascular events. Thromb Res, 128 (5): e62-6.
35. Minnema M, Peters R, De Winter R, et al (2000). Activation of clotting factors XI and IX in patients with acute myocardial infarction. Arterioscler Thromb Vasc Biol, 20 (11): 2489-93.
36. Salomon O, Steinberg D, Dardik R, et al (2003). Inherited factor XI deficiency confers no protection against acute myocardial infarction. J Thromb Haemost, 1 (4): 658-61.
37. Chougule A, Rajpal S, Ahluwalia J, et al (2016). Coagulation factor VIII, IX and XI levels in north Indian patients with venous thromboembolism: first study from India. Blood Coagul Fibrinolysis, 27 (1): 58-63.
38. Del Portillo JH, Echeverri D, Cabrales J (2019). Association of the use of manual thrombus aspiration with intracoronary thrombotic burden in patients with ST segment elevation myocardial infarction in the real world. Int J Cardiol Heart Vasc, 26: 100436.
39. Wang H, Rosendaal FR, Cushman M, et al (2021). Procoagulant factor levels and risk of venous thrombosis in the elderly. J Thromb Haemost, 19 (1): 186-193.
40. Rostamzadeh A, Khademvatani K (2016). Comparison of myocardial infarction outcome in opium dependent and non-dependent patients. Studies Med Sci, 27 (3): 208-14.
41. Aghadavoudi O, Eizadi-Mood N, Najarzadegan MR (2015). Comparing cardiovascular factors in opium abusers and non-users candidate for coronary artery bypass graft surgery. Adv Biomed Res, 4:12.
42. Hoseini SS, Saadatjoo SA, Nakhaee S, et al (2019). Potential effect of opium addiction on lipid profile and blood glucose concentration in type 2 diabetic patients in Iran. J Subst Use, 24 (4): 420-5.
| Files | ||
| Issue | Vol 54 No 3 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Opium Coagulation factor STEMI Myocardial infarction | ||
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How to Cite
1.
Azdaki N, Moezi Bady SA, Kazemi T, Najafzadeh M, Golestani A, Moradi-Poodeh A, Dadaei-Joushgheani H, Sajjadi SM. Opium Addiction and Coagulation Factors in ST-Segment Elevation Myocardial Infarction (STEMI) Patients: Implications for Thrombosis and Cardiovascular Outcomes. Iran J Public Health. 2025;54(3):654-662.
