Table 3.
Sex specific associations between prescription opioid use and acute coronary heart disease, cardiovascular death, stroke
|
|
All |
No baseline CHD |
Baseline CHD |
|||
|---|---|---|---|---|---|---|
| POU | Nonusers | POU | Nonusers | POU | Nonusers | |
| Acute coronary heart disease | ||||||
| MALES, n | 651 | 12,479 | 474 | 9,564 | 177 | 2,915 |
| Events, n | 38 | 842 | 22 | 446 | 16 | 396 |
| Age-adjusted IR (95%CI)‡ | 12.5 (9.1–17.3) | 12.1 (11.3–13.0) | 9.9 (6.5–15.0) | 8.2 (7.4–9.1) | 21.1 (17.5–34.5) | 27.7 (25.1–30.6) |
| HR (95%CI) † | 0.70 (0.50–0.97) | 0.89 (0.57–1.39) | 0.53 (0.32–0.87) | |||
| FEMALES, n | 1,200 | 14,695 | 964 | 12,967 | 236 | 1,728 |
| Events, n | 67 | 415 | 34 | 266 | 33 | 149 |
| Age-adjusted IR (95%CI)‡ | 11.1 (8.7–14.2)∗∗ | 5.1 (4.6–5.7) | 7.0 (5.0–9.9)∗∗ | 3.8 (3.3–4.3) | 33.7 (24.0–47.6)∗∗ | 17.7 (14.9–20.9) |
| HR (95%CI) † | 1.38 (1.05–1.82) | 1.22 (0.84–1.77) | 1.63 (1.08–2.45) | |||
| Sex x POU P-interaction¶ | 0.001 | 0.07 | 0.004 | |||
| Stroke | ||||||
| MALES, n | 650 | 12,476 | 594 | 11,615 | 56 | 861 |
| Events, n | 22 | 378 | 14 | 305 | 8 | 73 |
| Age-adjusted IR (95%CI)‡ | 7.1 (4.7–10.8) | 5.2 (4.7–5.8) | 4.8 (2.9–8.2) | 4.4 (3.9–5.0) | 34.6 (17.3–69.4) | 18.3 (14.5–23.1) |
| HR (95%CI) † | 1.07 (0.69–1.67) | 0.92 (0.53–1.59) | 1.59 (0.72–3.50) | |||
| FEMALES, n | 1200 | 14,692 | 1021 | 13,908 | 109 | 784 |
| Events, n | 33 | 316 | 27 | 260 | 6 | 56 |
| Age-adjusted IR (95%CI)‡ | 4.8 (2.9–8.2) | 4.4 (3.9–5.0) | 4.6 (3.1–6.7) | 3.1 (2.6–3.5) | 12.4 (5.6–27.7) | 15.4 (11.8–20.2) |
| HR (95%CI) † | 0.98 (0.68–1.43) | 1.16 (0.77–1.76) | 0.53 (0.21–1.32) | |||
| Sex x POU P-interaction§ | 0.90 | 0.38 | 0.08 | |||
| Cardiovascular death | ||||||
| MALES, n | 651 | 12,479 | 422 | 8,883 | 220 | 3,596 |
| Events, n | 32 | 651 | 12 | 265 | 20 | 386 |
| Age-adjusted IR (95%CI)‡ | 9.1 (6.4–12.9) | 7.5 (6.8–8.3) | 5.1 (2.9–9.1) | 4.0 (3.4–4.7) | 19.0 (12.3–29.5) | 19.2 (17.2–21.4) |
| HR (95%CI) † | 0.78 (0.54–1.11) | 0.83 (0.46–1.51) | 0.75 (0.47–1.18) | |||
| FEMALES, n | 1,200 | 14,695 | 873 | 12,225 | 327 | 2,470 |
| Events, n | 72 | 365 | 23 | 205 | 49 | 160 |
| Age-adjusted IR (95%CI)‡ | 9.6 (6.5–10.6)∗∗ | 3.6 (3.1–4.1) | 4.0 (2.6–6.1)∗ | 2.3 (1.2–2.7) | 32.0 (24.0–42.7)∗∗ | 11.9 (10.0–14.1) |
| HR (95%CI) † | 1.66 (1.27–2.17) | 1.15 (0.73–1.81) | 2.14 (1.51–3.03) | |||
| Sex x POU P-interaction# | 0.0001 | 0.17 | 0.0001 | |||
Abbreviations: CI = confidence interval; CHD = coronary heart disease; CVD = cardiovascular disease includes history of CHD, stroke, periphery artery disease or aortic aneurism; HR = hazards ratio; IR = incidence rate; POU = Prescription opioid user.
∗Significant difference between POU and nonusers at P < 0.05; ∗∗ significant–at P < 0.001.
Hazard Ratio and (95% Confidence Interval) for POU in the fully adjusted model (model 4) stratified by gender.
Age-adjusted Incidence Rate per 1,000 person-years (95% confidence interval).
From the fully adjusted model (model 4) of acute CHD.
From the fully adjusted model (model 4) of stroke.
From the fully adjusted model (model 4) of CVD death.
Bold P < 0.05.