Sonographic features of internal carotid artery in patients with opioid use disorder: Is opium a new risk factor for atherosclerosis of internal carotid artery?

Abstract

Background: Opium use disorder (OUD) is prevalent worldwide. Despite its traditional use, recent studies suggest that OUD may exacerbate atherosclerosis and ischemic stroke. This study investigates the effect of OUD on internal carotid artery sonographic findings using B-mode Doppler sonography.

Materials and methods: A case-control study was conducted in Isfahan, Iran, from 2021 to 2023. A total of 295 patients, including 95 with OUD and 200 without, were evaluated through medical records and B-mode Doppler sonography to assess atherosclerotic plaques, vulnerability of plaques, carotid artery stenosis, and carotid artery intima-media thickness (CIMT). Data on age, sex, smoking, and medical history were also collected.

Results: The OUD group had a higher prevalence of tobacco smoking (56% vs. 18%; P < 0.001). Atherosclerotic plaques were more common in OUD patients (83% vs. 65%; P = 0.001). Vulnerable plaques were more frequent in OUD patients (19% vs. 9%; P = 0.039). OUD patients were three times more likely to have carotid artery stenosis (85% vs. 65%; P < 0.001) and had a higher incidence of more than 70% stenosis (33.8% vs. 16%; P = 0.003). CIMT was significantly higher in the OUD group (0.95 mm vs. 0.87 mm; P < 0.001). Logistic regression analysis revealed that OUD was independently associated with atherosclerotic plaque, carotid stenosis, stenosis of more than 70%, and CIMT (P < 0.05).

Conclusion: This study highlights a significant association between OUD and sonographic markers of carotid atherosclerosis, including increased intima-media thickness, higher prevalence of atherosclerotic plaques, and stenosis of more than 70%. We suggest OUD as a potential risk factor for carotid artery atherosclerosis.