Abstract P370: Opioid and Gabapentinoid Medication Use and the Risks of Atrial Fibrillation and Supraventricular Ectopy in the Multi-ethnic Study of Atherosclerosis

Abstract

Purpose: Opioids and gabapentinoids may have adverse cardiovascular effects. We evaluated whether these medications were associated with incident clinically-detected atrial fibrillation (AF) or monitor-detected supraventricular ectopy (SVE), including premature atrial contractions (PACs) and supraventricular tachycardia (SVT). Methods: We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort study that enrolled 6,814 Americans without clinically-detected cardiovascular disease (CVD) in 2000-2002. At the 2016-2018 examination, a subset of participants received extended ambulatory electrocardiographic (ECG) monitoring with a device that records up to 14 days of continuous data. Longitudinal analyses investigated time-varying medication exposures at 5 exams (through 2012) and the risk of incident clinically-detected AF through 2015 using Cox proportional hazards regression models. Cross-sectional analyses investigated medication exposures at the 2016-2018 examination and the risk of monitor-detected SVE using linear and logistic regression models. Methods: The longitudinal cohort included 6,652 participants. Opioid and gabapentenoid use increased over time (Figure). During 12.4 years of mean follow-up, 961 participants (14.4%) experienced incident AF. Opioid use and gabapentinoid use were not associated with the risk of incident AF compared with no use. The cross-sectional analysis included 1,435 participants with ECG monitoring. Compared with non-use, gabapentinoid use was associated with an 84% greater count of PACs/hour (95% CI, 25%-171%) and with a 44% greater average number of runs of SVT/day (95% CI, 3%-100%) but not with a higher odds of SVT. No associations were found with use of opioids in cross-sectional analyses. Conclusions: In this study, gabapentinoid use was associated with more SVE. Given the rapid increase in gabapentinoid use, additional studies are needed to clarify whether these medications increase the risk of CVD complications.