Iranian Heart Journal

Iranian Heart Journal

Coronary Artery Calcium Score in Opium-Addicted and Non-Addicted Patients With Coronary Artery Disease: A Multivariate Regression Analysis

Document Type : Original Article

Authors
Masoomeh Kahnooj
Ali Nazari Jaaz
Maryam Aliramezani
Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences Kerman, IR Iran.
Abstract
Background: The effects of opium and opioids on coronary artery disease (CAD) have been a subject of growing interest in recent years. Nonetheless, their relationship with the coronary artery calcium (CAC) score, a predictive marker for CAD, has not been evaluated. This study aimed to investigate this association.
 
Methods: This cross-sectional study was conducted at three cardiac centers in Kerman, Iran (2022–2023). A total of 170 patients with suspected CAD (85 opium users and 85 non-users) referred for coronary CT angiography were enrolled. Opium use was assessed using DSM-5 criteria. The CAC score was measured by multi-detector computed tomography using the Agatston method. Multivariable linear regression was applied to examine the association between opium use and CAC score, adjusting for cardiovascular risk factors.
 
Results: Among 170 participants (85 in each group), mean diastolic blood pressure was significantly higher in patients with opium or opioid addiction (P = 0.003), while serum total cholesterol (P = 0.034) and low-density lipoprotein levels (P = 0.043) were significantly lower. Patients with addiction also had significantly higher mean CAC scores (P = 0.034). In the multivariable regression model, only cigarette smoking history remained significantly associated with CAC score (β 0.477; P = 0.025). The effects of other variables, including opium use (P = 0.875), were not significant.
 
Conclusions: Chronic opium or opioid use does not appear to influence the severity of coronary artery calcification. Other risk factors, such as cigarette smoking, may play a more important role and should be further investigated. (Iranian Heart Journal 2025; 26(4): 57-68)
Keywords
Coronary artery disease
Calcium score
Opium
Opioids
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Iranian Heart Journal
Volume 26, Issue 4
Autumn 2025
Pages 57-68