School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Int J Cardiol. 2024 Oct 15;413:132404. doi: 10.1016/j.ijcard.2024.132404. Epub 2024 Jul 27.
Prescription opioid use (POU) has been shown to lead to cardiovascular disease (CVD), but its association with heart failure has not been well studied. We investigated the potential causal association between POU and HF using cohort studies and Mendelian Randomization (MR) analysis.
Initially, we examined the longitudinal association between POU and HF using the data from the Health and Retirement Study (HRS) and the UK biobank. Next, we employed a two-sample MR analysis using summary statistics from genome-wide association studies (GWAS) to assess the potential causal associations between POU and HF.
During a median of 3.8 and 13.8 years of follow-up, there were 441(8.04 per 1000 person-year) and 16,170 (3.96 per 1000 person-year) HF cases in the HRS and the UK biobank, respectively. After adjusting for covariates, participants who used prescription opioids had a 32% increased risk of developing HF, compared with non-users (HR = 1.32, 95%CI: 1.26-1.38, P < 0.001). In the MR analysis, summary statistics for POU were obtained from 78,808 UK Biobank study participants, and summary data for HF were obtained from 218,792 participants of a European population. A causal effect of genetic liability for POU on an increased risk of HF (OR = 1.16, 95% CI = 1.06, 1.27, P = 0.001) was suggested. The results were generally consistent in the sensitivity analysis, and no pleiotropy or heterogeneity were observed.
POU is associated with a high risk of HF. Our findings provide new insight into prescription opioid use among populations at risk of heart failure. More studies are needed to validate our results and further investigate the underlying mechanisms.
处方阿片类药物的使用（POU）已被证明与心血管疾病（CVD）有关，但它与心力衰竭之间的关系尚未得到很好的研究。我们使用队列研究和孟德尔随机化（MR）分析来研究 POU 和 HF 之间的潜在因果关系。
最初，我们使用健康与退休研究（HRS）和英国生物库的数据检查了 POU 和 HF 之间的纵向关联。接下来，我们使用来自全基因组关联研究（GWAS）的汇总统计数据进行两样本 MR 分析，以评估 POU 和 HF 之间的潜在因果关系。
在中位数为 3.8 年和 13.8 年的随访期间，HRS 和英国生物库中分别有 441 例（每 1000 人年 8.04 例）和 16170 例（每 1000 人年 3.96 例）HF 病例。调整协变量后，与非使用者相比，使用处方阿片类药物的参与者发生 HF 的风险增加了 32%（HR=1.32，95%CI：1.26-1.38，P<0.001）。在 MR 分析中，POU 的汇总统计数据来自 78808 名英国生物库研究参与者，HF 的汇总数据来自 218792 名欧洲人群参与者。遗传易感性增加 POU 与 HF 风险增加之间存在因果关系（OR=1.16，95%CI=1.06，1.27，P=0.001）。敏感性分析结果基本一致，未观察到混杂或异质性。
POU 与 HF 风险增加相关。我们的研究结果为高危人群的处方阿片类药物使用提供了新的见解。需要进一步的研究来验证我们的结果并进一步探讨潜在的机制。
