Is kratom (Mitragyna speciosa Korth.) use associated with ECG abnormalities? Electrocardiogram comparisons between regular kratom users and controls

Abstract

Objectives

Little is known about the cardiotoxic effects of kratom (Mitragyna speciosa Korth.), a medicinal plant. This analytical cross-sectional study investigated the prevalence of electrocardiogram (ECG) abnormalities and QTc intervals in regular kratom users compared with non-kratom-using control subjects.

Methods

We enrolled regular kratom users and non-kratom-using control subjects from three communities. Demographic data, clinical data, kratom use characteristics, and ECG findings were recorded. The mitragynine content of kratom juice was quantified using a validated gas chromatography–mass spectrometry (GC–MS) method.

Results

A total of 200 participants (100 kratom users and 100 control subjects) participated in this study. The prevalence of ECG abnormalities in kratom users (28%) did not differ from that of control subjects (32%). Kratom use was not associated with ECG abnormalities, except for significantly higher odds of sinus tachycardia (OR = 8.61, 95% CI = 1.06–70.17, p = 0.035) among kratom users compared with control subjects. The odds of observing borderline QTc intervals were significantly higher for kratom users compared with control subjects, regardless of the age of first use, the duration of use, the daily quantity consumed, and the length of time that had elapsed between last kratom use and ECG assessment. Nevertheless, there were no differences in the odds of having prolonged QTc intervals between kratom users and controls. The estimated average daily intake of mitragynine consumed by kratom users was 434.28 mg.

Conclusion

We found no link between regular kratom use and electrocardiographic abnormalities with an estimated average daily intake of 434.28 mg of mitragynine.

Keywords:

• Kratom
• ECG abnormalities
• mitragynine
• cardiotoxicity
• prolonged QTc interval

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Acknowledgements

The authors thank the Ministry of Education Malaysia for funding the research project. The authors also thank the members of the staff nurses of Advanced Medical and Dental Institute, Universiti Sains Malaysia for their assistance in data collection.

Disclosure statement

Jack E. Henningfield provides consulting support through Pinney Associates on pharmaceutical products, cannabinoids, and the dietary industry, as well as to the American Kratom Association.

Additional information

Funding

This study was funded by the Fundamental Research Grant Scheme of the Ministry of Education Malaysia [203.CIPPT.6711626].