Abstract 12773: Association of Opioid Use With Atrial Fibrillation in a Post-9/11 Veteran Population

IntroductionRisks of the current opioid epidemic have traditionally focused on overdoses, but recent studies have shown opioid use is an independent risk factor for cardiovascular mortality. One contributing factor to this association is speculated to be increased risk for cardiac arrhythmias such as atrial fibrillation (AF) due to sleep-disordered breathing that can accompany opioid abuse. The aim of this study was to assess if opioid use is independently associated with AF in a large cohort of young Veterans with few baseline comorbidities.MethodsAdministrative and clinical data, including patient demographics and clinical comorbidities based on ICD-9 codes for a large cohort of post-9/11 Veterans was utilized. Information on opioid use by prescription data for the year 2014-2015 was also acquired. Multivariate logistical regression analysis was performed to determine the association between opioid use and AF, adjusting for demographic, medical, and mental health covariates. Opioid use was further subdivided by duration of use within the study window.Results857,283 Veterans were included in the study sample, with a mean age of 38 (SD 9.5), 12.7% of whom were female, 59.0% White, 14.1% African American, and 11.0% Hispanic. Overall, 3,033 (0.354%) Veterans in the study cohort had a diagnosis of AF. Among those with AF, 29.2% were prescribed opioids, compared to 15.4% of Veterans without AF. Opioid prescription was independently associated with the likelihood of having AF after adjusting for demographic, medical, and mental health covariates including those with known associations to AF risk (OR= 1.34, 95% CI [1.23 - 1.45], p < 0.001). There was no significant trend observed with regard to duration of opioid prescription in the study window and AF prevalence.ConclusionThis analysis of nationwide data demonstrates the independent association of opioid use to diagnosed AF. The cohort is notable for relatively young age for observed AF prevalence. Given the contribution of AF to incident cardiovascular events, these findings indicate one pathway by which opioid use may contribute to cardiovascular mortality.