Abstract 13429: Association of Periprocedural Opiate Exposure During Cardiac Catheterization and Long-Term Opiate Dependence

Introduction: Recent data suggest that a brief exposure to opiates during medical encounters may lead to their higher use long-term. In this study we investigated the association of peri-procedural opiate exposure with incident opiate dependence disorder (ODD) for patients undergoing invasive cardiac catheterization (ICC)

Methods: The Veterans Affairs national electronic medical records for patients undergoing an ICC between 01/01/2010 and 01/01/2018 were extracted. Patients with ODD prior to the ICC date were excluded from analysis. Peri-procedural opiate use was defined as receiving morphine or fentanyl within 24 hours before or after the ICC. ODD was diagnosed using international classification of disease (ICD) 9 ^th and 10 ^th version codes. Opiates evaluated included morphine, fentanyl, or other opiates (e.g., codeine, hydrocodone, and methadone). Follow up period extended to 01/01/2020.

Results: From 01/01/2010 to 01/01/2018, 223,436 patients underwent ICC; of these, 215,841 had no prior ODD. New ODD was identified in 2710 (5.80%) of the 46,624 patients who received opiates peri-procedurally compared to 3,666 (2.16%) of the 169,217 patients who did not receive opiates peri-procedurally, p-value < 0.01.

Conclusions: Brief peri-procedural use of opiates in patients undergoing ICC may lead to long-term opiate dependence disorder. Further research to validate these results are warranted. Potential alternatives to opiates must be considered for such patients.