Effects of opium use on one-year major adverse cardiovascular events (MACE) in the patients with ST-segment elevation MI undergoing primary PCI: a propensity score matched - machine learning based study.

Background: Considerable number of people still use opium worldwide and many believe in opium's health benefits. However, several studies proved the detrimental effects of opium on the body, especially the cardiovascular system. Herein, we aimed to provide the first evidence regarding the effects of...

Descripción completa

Detalles Bibliográficos
Publicado en:BMC Complementary Medicine & Therapies Vol. 23; no. 1; pp. 1 - 18
Autores principales: Jenab, Yaser, Hedayat, Behnam, Karimi, Amirali, Taaghi, Sarah, Ghorashi, Seyyed Mojtaba, Ekhtiari, Hamed
Formato: equations & formulas research tables/charts Journal Article
Publicado: BioMed Central 1/19/2023
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161397339&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 161397339
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        26627671
        MFH8
      jtl: BMC Complementary Medicine & Therapies
      issn: 26627671
      maglogo: N
    pubinfo:
      dt: 1/19/2023
      vid: 23
      iid: 1
      pid: 24147
      pub: BioMed Central
    artinfo:
      ui:
        161397339
        161397339
        161397339
        10.1186/s12906-023-03833-z
        161397339
      ppf: 1
      ppct: 17
      formats:
      tig:
        atl: Effects of opium use on one-year major adverse cardiovascular events (MACE) in the patients with ST-segment elevation MI undergoing primary PCI: a propensity score matched - machine learning based study.
      aug:
        au:
          Jenab, Yaser
          Hedayat, Behnam
          Karimi, Amirali
          Taaghi, Sarah
          Ghorashi, Seyyed Mojtaba
          Ekhtiari, Hamed
        affil: Professor of Cardiology, Fellowship of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
      sug:
        subj:
          Opium Adverse Effects
          Opium Therapeutic Use
          ST Elevation Myocardial Infarction Physiopathology
          Major Adverse Cardiac Events Risk Factors
          Machine Learning Methods
          Risk Assessment
          Percutaneous Coronary Intervention
          Human
          Male
          Female
          Prospective Studies
          Kaplan-Meier Estimator
          Survival Analysis
          Confidence Intervals
          Retrospective Design
          Univariate Statistics
          Cox Proportional Hazards Model
          Male
          Female
      ab: Background: Considerable number of people still use opium worldwide and many believe in opium's health benefits. However, several studies proved the detrimental effects of opium on the body, especially the cardiovascular system. Herein, we aimed to provide the first evidence regarding the effects of opium use on one-year major adverse cardiovascular events (MACE) in the patients with ST-elevation MI (STEMI) who underwent primary PCI. Methods: We performed a propensity score matching of 2:1 (controls: opium users) that yielded 518 opium users and 1036 controls. Then, we performed conventional statistical and machine learning analyses on these matched cohorts. Regarding the conventional analysis, we performed multivariate analysis for hazard ratio (HR) of different variables and MACE and plotted Kaplan Meier curves. In the machine learning section, we used two tree-based ensemble algorithms, Survival Random Forest and XGboost for survival analysis. Variable importance (VIMP), tree minimal depth, and variable hunting were used to identify the importance of opium among other variables. Results: Opium users experienced more one-year MACE than their counterparts, although it did not reach statistical significance (Opium: 72/518 (13.9%), Control: 112/1036 (10.8%), HR: 1.27 (95% CI: 0.94–1.71), adjusted p-value = 0.136). Survival random forest algorithm ranked opium use as 13th, 13th, and 12th among 26 variables, in variable importance, minimal depth, and variable hunting, respectively. XGboost revealed opium use as the 12th important variable. Partial dependence plot demonstrated that opium users had more one-year MACE compared to non-opium-users. Conclusions: Opium had no protective effects on one-year MACE after primary PCI on patients with STEMI. Machine learning and one-year MACE analysis revealed some evidence of its possible detrimental effects, although the evidence was not strong and significant. As we observed no strong evidence on protective or detrimental effects of opium, future STEMI guidelines may provide similar strategies for opium and non-opium users, pending the results of forthcoming studies. Governments should increase the public awareness regarding the evidence for non-beneficial or detrimental effects of opium on various diseases, including the outcomes of primary PCI, to dissuade many users from relying on false beliefs about opium's benefits to continue its consumption.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N