Virginia Via Research Day Book 2026

Medical Student Research Biomedical

25 The Effect of Concomitant Use of Opioids and Alcohol on Cardiovascular Outcomes, A Retrospective Cohort Study

David G.L. Roach, MPH OMS-II; Tej Patel, OMS-II; Elizabeth Miller, OMS-II Corresponding author: tpatel@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

Context: The WHO recognizes Cardiovascular Diseases (CVD) as the leading cause of morbidity and mortality globally, accounting for 32% of deaths in 2022, corroborated by the Department of Health and Human Services identifies CVD as the leading cause of death for both men and women in the United States. Alcohol Use Disorder (AUD) is estimated to affect 1 in 10 Americans over the age of 12, while an estimated 3.2% have been diagnosed with Opioid Use Disorder (OUD). Long-term use of alcohol is known to have a cardiovascular impact, while less is known about the impact that the common practice of concomitant use has on cardiovascular outcomes in this population. Objective and/or Hypothesis: To determine whether the concomitant use of opioids and alcohol increases the risk of major cardiovascular complications, such as cardiac arrest, endocarditis, Takotsubo cardiomyopathy, and ventricular arrhythmias, compared to opioid or alcohol use alone, using phenotyped cohorts from the All of Us database.

Methods: To test our hypothesis, we employed a retrospective cohort study design. Primary and secondary data were collected from the All of Us (AoU) database and organized into cohorts for analysis. These cohorts consisted of the presence of cardiac complications after being diagnosed with opioid abuse, after being diagnosed with alcohol abuse, and after being diagnosed with concomitant opioid and alcohol abuse. Control cohorts consisted of patients with diagnosed opioid abuse, alcohol abuse, or concomitant opioid and alcohol abuse, and no history of major cardiovascular complications. Patients with diagnoses related to the misuse of cocaine, benzodiazepines, or stimulants were excluded from the cohorts in order to minimize confounding variables. The incidence of major cardiovascular complications was defined as a diagnosis of cardiac arrest, endocarditis, Takotsubo cardiomyopathy, or ventricular arrhythmia. The proportion of patients diagnosed with alcohol abuse, opioid abuse, or both who developed cardiac complications was compared with a chi-squared test.

Results: The study is in progress, and final results will be available at the time of presentation. However, our preliminary data yielded 98 participants with major cardiovascular complications following a diagnosis of opioid abuse, 311 participants with complications following alcohol abuse, and 382 participants with complications following concomitant opioid and alcohol abuse. Conclusion(s): Based on preliminary cohort studies, individuals with concomitant opioid and alcohol use appear to have a higher burden of cardiovascular complications than those with opioid use alone; however, definitive conclusions cannot be drawn yet until full statistical analysis is completed. We aim to utilize the findings of this study to inform future clinical understanding and research directions in the management of substance-related cardiovascular disease.

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114 Edward Via College of Osteopathic Medicine (VCOM)