Cannabis et infarctus du myocarde du sujet jeune : association fortuite ? À propos d’une observation

Leblanc, A.; Tirel-Badets, Anne; Paleiron, Nicolas; Castellant, Philippe; Cornily, J.-C.; Meynier, André; Grassin, F.; Feuvrier, Y.; Blanchard, C.; Zagnoli, Fabien; Quiniou, G.; Vinsonneau, Ulric

doi:10.1016/j.ancard.2010.12.018

Cited by 17 publications

(2 citation statements)

References 14 publications

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“…In our previous studies using the National Inpatient Sample and Behavioral Risk Factor Surveillance System (BRFSS) database from the CDC, we observed rising trends and positive associations of cannabis use with stroke events in young adults [ 32 , 33 ]. This is thought to be multifocal angiopathy in young individuals [ 34 ] or a cannabis-related consequence of arterial obstruction from a post-myocardial infarction left ventricular thrombus [ 35 ]. Though the frequency of tobacco use disorder, alcohol abuse, depression, history of previous myocardial infarction, valvular heart disease and pulmonary circulation disease were higher in HC hospitalizations for CUD+ cohort than CUD-, these comorbidities were not independently associated with higher MACCE in CUD+ compared to CUD-.…”

Section: Discussionmentioning

confidence: 99%

Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis

et al. 2022

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Background and Objectives: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). Material and Methods: Young adult hospitalizations (18–44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015–December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. Results: Young CUD+ had higher prevalence of HC (0.7%, n = 4675) than CUD- (0.5%, n = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06–1.24, p = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01–1.36, p = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, p = 0.154). Propensity-matched CUD+ cohort (n = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55–12.91, p < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38–2.17, p < 0.001) and stroke (aOR 1.46, 95%CI:1.02–2.10, p = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. Conclusions: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.

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Section: Discussionmentioning

confidence: 99%

Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis

et al. 2022

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“…These are mediated by CB1 and CB2 receptors in the vasculature [ 2 ]. Spontaneous coronary artery dissection (SCAD) has been reported in association with cannabis use even in normal coronary arteries [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Cannabis-Induced ST-Segment Elevation Myocardial Infarction With Possible Coronary Artery Dissection: A Case Report

Arshad,

Mousa,

Oudah

et al. 2023

Cureus

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Spontaneous coronary artery dissection is a rare and commonly underdiagnosed cause of acute coronary syndrome. Here, we report the case of a 36-year-old male patient who presented with an acute onset of left-sided chest pain, preceded by several hours of nausea and vomiting. Past medical history was significant for chronic marijuana use and multiple episodes of nausea and vomiting requiring multiple hospitalizations. Urinary drug screen was positive for cannabinoids only, and electrocardiography revealed an ST-segment elevation myocardial infarction. This was complicated by an episode of ventricular fibrillation that was successfully defibrillated and prompted cardiac catheterization, which revealed a coronary intraluminal filling defect and a segmental lesion, suggestive of coronary dissection. No evidence of atherosclerotic plaque was noticed. Stent placement and thrombectomy were pursued and the patient was stabilized. As cannabinoid use is gaining legality and becoming widespread, this case aims to enhance physicians’ awareness of potentially life-threatening complications of its use.

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Coronary thrombosis and marijuana smoking: a case report and narrative review of the literature

Marchetti

Matteis

et al. 2015

Drug Testing and Analysis

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We encountered evidence of myocardial infarction due to coronary thrombosis in an autopsy of an occasional marijuana smoker. These findings prompted us to perform a narrative review of the literature to determine when post-mortem toxicological tests may support a temporal relationship between marijuana smoking and cardiovascular disease. Toxicological examination showed the presence of Δ-9-tetrahydrocannabinol, its main metabolite and cannabinol in blood and urine. Quali-quantitative analysis revealed that Δ-9-tetrahydrocannabinol was taken within 2 h of the onset of cardiovascular symptoms, according to circumstantial data. Post-mortem toxicological results must take into account the degradation and post-mortem redistribution of analytes. However, for any inference about the specific cardiovascular triggering effect of Δ-9-tetrahydrocannabinol intake, we maintain that cannabinoid analysis in blood samples must be considered an essential requirement to estimate the time of last intake and avoid incomplete documentation. The literature, combined with the present case report, highlights an association between marijuana use and negative cardiovascular events, although few authors have supported their conclusions with toxicological results. Thus, additional research is needed.

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Cannabis et infarctus du myocarde du sujet jeune : association fortuite ? À propos d’une observation

Cited by 17 publications

References 14 publications

Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis

Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis

Cannabis-Induced ST-Segment Elevation Myocardial Infarction With Possible Coronary Artery Dissection: A Case Report

Coronary thrombosis and marijuana smoking: a case report and narrative review of the literature

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