Does opium have benefit for coronary artery disease? A systematic review

Opium is a plant with euphoria effect. People from some parts of the world traditionally use opium for cardioprotective effects. We did a systematic review to assess the effect of opium on coronary artery disease (CAD). A systematic database search was conducted in PubMed, Web of Science, Google Scholar, Cochrane library, Scopus, and SID from their onset up to June 2016. The quality of the studies was assessed with a standardized scoring system. Articles assessing the effect of opium consumption as orally or smoked were included in this review. Outcome was defined as age on CAD disease, risk of CAD, and morbidity from CAD. Poor methodological studies, animal studies, and studies on cardiovascular risk factors or serum markers were excluded from the review. Three case–control, three cohort, and eight cross-sectional studies were included in this systematic review. The age at the occurrence of myocardial infarction, coronary bypass surgery, and percutaneous intervention in opium users was signifi cantly lower than that of nonusers. Odds ratio of opium consumption for CAD ranged from 1.3 to 3.8 in different studies. Hazard ratio of opium consumption for ischemic heart disease was 1.90 (1.57–2.29) with modification by sex, ethnicity, education level, marital status, residential place, and cigarette smoking. We concluded, in spite of the traditional belief, that the current evidence did not support the protective effect of opium on CAD. Future well-designed studies concerning probable confounders in Iran and other similar parts of world are required.