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
Abstract 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 ef...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Complementary Medicine and Therapies |
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| Online Access: | https://doi.org/10.1186/s12906-023-03833-z |
| _version_ | 1797946113870790656 |
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| author | Yaser Jenab Behnam Hedayat Amirali Karimi Sarah Taaghi Seyyed Mojtaba Ghorashi Hamed Ekhtiari |
| author_facet | Yaser Jenab Behnam Hedayat Amirali Karimi Sarah Taaghi Seyyed Mojtaba Ghorashi Hamed Ekhtiari |
| author_sort | Yaser Jenab |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-10T21:05:45Z |
| format | Article |
| id | doaj.art-c363eb676ee3425d99139e6f7213870b |
| institution | Directory Open Access Journal |
| issn | 2662-7671 |
| language | English |
| last_indexed | 2024-04-10T21:05:45Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Complementary Medicine and Therapies |
| spelling | doaj.art-c363eb676ee3425d99139e6f7213870b2023-01-22T12:04:38ZengBMCBMC Complementary Medicine and Therapies2662-76712023-01-0123111710.1186/s12906-023-03833-zEffects 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 studyYaser Jenab0Behnam Hedayat1Amirali Karimi2Sarah Taaghi3Seyyed Mojtaba Ghorashi4Hamed Ekhtiari5Professor of Cardiology, Fellowship of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical SciencesAssistant professor of Cardiology, Tehran Heart Center, Tehran University of Medical SciencesSchool of medicine, Tehran University of Medical SciencesCardiologist, Tehran University of Medical SciencesCardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical SciencesDepartment of Psychiatry, University of MinnesotaAbstract 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.https://doi.org/10.1186/s12906-023-03833-zMachine learningMajor adverse cardiovascular eventsMortality,Myocardial infarctionOpiumPercutaneous coronary intervention |
| spellingShingle | Yaser Jenab Behnam Hedayat Amirali Karimi Sarah Taaghi Seyyed Mojtaba Ghorashi Hamed Ekhtiari 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 Machine learning Major adverse cardiovascular events Mortality,Myocardial infarction Opium Percutaneous coronary intervention |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Machine learning Major adverse cardiovascular events Mortality,Myocardial infarction Opium Percutaneous coronary intervention |
| url | https://doi.org/10.1186/s12906-023-03833-z |
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