Chronic opioid use for noncancer pain and risk of cardiovascular events: a National Health Insurance database analysis.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2026-06-01 Epub Date: 2025-12-09 DOI:10.1097/MCA.0000000000001601

Jeonggeun Moon, In Cheol Hwang, Hyunsun Lim, Youngmin Park

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引用次数: 0

Abstract

Objective: Although opioids primarily act on the central nervous system, they also affect the cardiovascular (CV) system. This study aimed to examine the association between long-term opioid use and the risk of CV events in individuals with noncancer pain.

Methods: We conducted a nationwide observational cohort study using data from the Korean National Health Insurance Service, linked to the national health check-up database, between 2009 and 2018. Patients prescribed opioids for ≥90 days were defined as chronic users. After 1:10 propensity score matching, Cox proportional hazards models were used to estimate the risk of myocardial infarction (MI) and ischaemic stroke (IS), reported as hazard ratios (HRs) with 95% confidence intervals (CIs), compared to nonopioid users.

Results: The final analysis included 36 300 opioid users and 334 590 matched controls. Chronic opioid use was significantly associated with increased risk of MI (HR 1.20, 95% CI: 1.12-1.30; P = 0.001) and IS (HR 1.16, 95% CI: 1.12-1.21; P < 0.001). Subgroup analyses indicated that the association between opioid use and CV events varied by factors such as prior major CV diseases, anticoagulant use, area of residence, and gabapentinoid use.

Conclusion: Long-term opioid use in patients with noncancer pain is associated with an increased risk of CV events. These findings underscore the need for careful CV risk assessment when initiating or maintaining chronic opioid treatment.

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慢性阿片类药物用于非癌症疼痛和心血管事件风险：国家健康保险数据库分析。

目的：虽然阿片类药物主要作用于中枢神经系统，但它们也影响心血管系统。本研究旨在研究非癌性疼痛患者长期使用阿片类药物与心血管事件风险之间的关系。方法：我们在2009年至2018年期间使用韩国国民健康保险服务中心与国家健康检查数据库相关联的数据进行了一项全国性的观察性队列研究。处方阿片类药物≥90天的患者被定义为慢性使用者。在1:10倾向评分匹配后，与非阿片类药物使用者相比，使用Cox比例风险模型来估计心肌梗死（MI）和缺血性卒中（IS）的风险，报告为95%置信区间（CIs）的风险比（hr）。结果：最终分析包括36 300名阿片类药物使用者和334 590名匹配的对照组。慢性阿片类药物使用与心肌梗死（HR 1.20, 95% CI: 1.12-1.30; P = 0.001）和IS （HR 1.16, 95% CI: 1.12-1.21； P）风险增加显著相关。结论：非癌性疼痛患者长期使用阿片类药物与心血管事件风险增加相关。这些发现强调了在开始或维持慢性阿片类药物治疗时仔细评估心血管风险的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.