{"doi":"10.1093/eurjpc/zwaa006","title":"Long-term opiate use and risk of cardiovascular mortality: results from the Golestan Cohort Study","abstract":"AIMS: Tens of millions of people worldwide use opiates but little is known about their potential role in causing cardiovascular diseases. We aimed to study the association of long-term opiate use with cardiovascular mortality and whether this association is independent of the known risk factors. METHODS AND RESULTS: In the population-based Golestan Cohort Study-50 045 Iranian participants, 40-75 years, 58% women-we used Cox regression to estimate hazard ratios and 95% confidence intervals (HRs, 95% CIs) for the association of opiate use (at least once a week for a period of 6 months) with cardiovascular mortality, adjusting for potential confounders-i.e. age, sex, education, wealth, residential place, marital status, ethnicity, and tobacco and alcohol use. To show independent association, the models were further adjusted for hypertension, diabetes, waist and hip circumferences, physical activity, fruit/vegetable intake, aspirin and statin use, and history of cardiovascular diseases and cancers. In total, 8487 participants (72.2% men) were opiate users for a median (IQR) of 10 (4-20) years. During 548 940 person-years-median of 11.3 years, >99% success follow-up-3079 cardiovascular deaths occurred, with substantially higher rates in opiate users than non-users (1005 vs. 478 deaths/100 000 person-years). Opiate use was associated with increased cardiovascular mortality, with adjusted HR (95% CI) of 1.63 (1.49-1.79). Overall 10.9% of cardiovascular deaths were attributable to opiate use. The association was independent of the traditional cardiovascular risk factors. CONCLUSION: Long-term opiate use was associated with an increased cardiovascular mortality independent of the traditional risk factors. Further research, particularly on mechanisms of action, is recommended.","journal":"European Journal of Preventive Cardiology","year":2020,"id":98215,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":32,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7526,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":276717,"name":"Ramin Shakeri","orcid":null,"position":1,"is_corresponding":false},{"id":275784,"name":"Hossein Poustchi","orcid":"0000-0003-4566-3628","position":2,"is_corresponding":false},{"id":39080,"name":"Akram Pourshams","orcid":"0000-0002-7950-3983","position":3,"is_corresponding":false},{"id":48371,"name":"Arash Etemadi","orcid":"0000-0002-3458-1072","position":4,"is_corresponding":false},{"id":23097,"name":"Farhad Islami","orcid":"0000-0002-7357-5994","position":5,"is_corresponding":false},{"id":275785,"name":"Masoud Khoshnia","orcid":"0000-0001-7352-8058","position":6,"is_corresponding":false},{"id":276718,"name":"Abdolsamad Gharavi","orcid":null,"position":7,"is_corresponding":false},{"id":22770,"name":"Gholamreza Roshandel","orcid":"0000-0002-5494-0722","position":8,"is_corresponding":false},{"id":275786,"name":"Hooman Khademi","orcid":"0000-0001-8145-1724","position":9,"is_corresponding":false},{"id":275788,"name":"Mahdi Zahedi","orcid":"0000-0002-3609-5190","position":10,"is_corresponding":false},{"id":275789,"name":"Behnoush Abedi‐Ardekani","orcid":"0000-0002-0980-0587","position":11,"is_corresponding":false},{"id":300673,"name":"Rajesh Vedanthan","orcid":"0000-0001-7138-2382","position":12,"is_corresponding":false},{"id":265963,"name":"Paolo Boffetta","orcid":"0000-0002-3811-2791","position":13,"is_corresponding":false},{"id":275790,"name":"Sanford M. Dawsey","orcid":"0000-0003-2185-0533","position":14,"is_corresponding":false},{"id":485715,"name":"Paul D Pharaoh","orcid":null,"position":15,"is_corresponding":false},{"id":275791,"name":"Masoud Sotoudeh","orcid":"0000-0003-1597-4150","position":16,"is_corresponding":false},{"id":217938,"name":"Christian C. Abnet","orcid":"0000-0002-3008-7843","position":17,"is_corresponding":false},{"id":366904,"name":"Nicholas Day","orcid":"0000-0003-0291-436X","position":18,"is_corresponding":false},{"id":13291,"name":"Paul Brennan","orcid":"0000-0002-0518-8714","position":19,"is_corresponding":false},{"id":109603,"name":"Farin Kamangar","orcid":"0000-0003-4169-7978","position":20,"is_corresponding":false},{"id":275792,"name":"Reza Malekzadeh","orcid":"0000-0002-9820-6335","position":21,"is_corresponding":false},{"id":484866,"name":"Mahdi Nalini","orcid":"0000-0002-7464-9756","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-18T22:36:34.157932Z","pmid":"33624066","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}