Could Opioids Increase Cardiac Death Risk in Older COPD Patients?

New opioid use is associated with increased risk of ischemic heart disease (IHD)-related morbidity and mortality in older adults with COPD, according to a recent study.

In their exploratory, retrospective cohort study, researchers examined data from 134,408 community-dwelling individuals and 14,685 long-term care residents with COPD in Ontario, Canada, 67% and 60.6% of whom were given an incident opioid.
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Overall, incident use of an opioid was associated with significantly decreased rates of emergency room visits and hospitalization for congestive heart failure among the community-dwelling group, and significantly increased rates of IHD-related mortality in the long-term care group. Rates of emergency room visits and hospitalizations for IHD and IHD-related mortality were also significantly increased in members of the community-dwelling group who used potent opioid-only agents without aspirin or acetaminophen.

“Adverse cardiac events may need to be considered when administering new opioids to older adults with COPD, but further studies are required to establish if the observed associations are causal or related to residual confounding,” the researchers concluded.

—Michael Potts

Reference:

Vozoris NT, Wang X, Austin PC, et al. Adverse cardiac events associated with incident opioid drug use among older adults with COPD [published online June 29, 2017]. Eur J Clin Pharmacol. doi:10.1007/s00228-017-2278-3