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

BMC Complementary Medicine and Therapies

Research

Behnam Hedayat¹  Sarah Taaghi²  Seyyed Mojtaba Ghorashi³  Hamed Ekhtiari⁴  Yaser Jenab⁵  Amirali Karimi⁶ 

[1] Assistant professor of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran;Cardiologist, Tehran University of Medical Sciences, Tehran, Iran;Assistant professor of cardiology, Iran University of medical sciences, Tehran, Iran;Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran;Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA;Professor of Cardiology, Fellowship of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran;School of medicine, Tehran University of Medical Sciences, Tehran, Iran;

关键词: Machine learning;    Major adverse cardiovascular events;    Mortality,Myocardial infarction;    Opium;    Percutaneous coronary intervention;   

DOI  :  10.1186/s12906-023-03833-z

 received in 2022-06-02, accepted in 2023-01-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundConsiderable 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.MethodsWe 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.ResultsOpium 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.ConclusionsOpium 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.

【 授权许可】

CC BY   
© The Author(s) 2023

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