Data from: Reduction in arterial stiffness and vascular age by naltrexone-induced interruption of opiate agonism

Objective: To prospectively assess if opiate antagonist treatment or the
opiate-free status could reverse opiate-related vasculopathy. Design:
Longitudinal Open Observational, Serial “N of One”, over 6.5 years under
various treatment conditions: opiate dependence, naltrexone and
opiate-free. Setting: Primary care, Australia. Participants: 20 opiate
dependent patients (16 males: 16 cases of buprenorphine 4.11+1.17mg, two
of methadone 57.5+12.5mg and two of heroin 0.75+0.25g). Intervention:
Studies of Central Arterial Stiffness and vascular reference age (RA) were
performed longitudinally by SphygmoCor Pulse Wave Analysis (AtCor,
Sydney). Primary Outcomes: Primary outcome was vascular age and arterial
stiffness accrual under different treatment conditions. Results: The mean
chronological age (CA) was 33.62+2.03 years. The opiate-free condition was
associated with a lower apparent vascular age both in itself (males:
P=0.0402, females: P=0.0360) and in interaction with time (males:
P=0.0001; females: P=0.0004), and confirmed with other measures of
arterial stiffness. The mean modelled RA was 38.82, 37.73 and 35.05 years
in the opiate, naltrexone and opiate-free conditions respectively. The
opiate-free condition was superior to opiate agonism after full
multivariate adjustment (P=0.0131), with modelled RA/CA of 1.0173, 0.9563,
and 0.8985 (reductions of 6.1% and 11.9% respectively). Conclusions: Data
demonstrate that opiate-free status improves vascular age and arterial
stiffness in previous chronic opiate users.. The role of opiate antagonist
treatment in achieving these outcomes requires future clarification and
offers hope of novel therapeutic remediation.