Marijuana use and coronary artery disease in young adults

Abstract

Background Marijuana is the most popular drug of abuse in the United States. The association between its use and coronary artery disease has not yet been fully elucidated. This study aims to determine the frequency of coronary artery disease among young to middle aged adults presenting with chest pain who currently use marijuana as compared to nonusers. Methods In this retrospective study, 1,420 patients with chest pain or angina equivalent were studied. Only men between 18 and 40 years and women between 18 and 50 years of age without history of cardiac disease were included. All patients were queried about current or prior cannabis use and underwent coronary CT angiography. Each coronary artery on coronary CT angiography was assessed based on the CAD-RADS reporting system. Results A total of 146 (10.3%) out of 1,420 patients with chest pain were identified as marijuana users. Only 6.8% of the 146 marijuana users had evidence of coronary artery disease on coronary CT angiography. In comparison, the rate was 15.0% among the 1,274 marijuana nonusers (p = 0.008). After accounting for other cardiac risk factors in a multivariate analysis, the negative association between marijuana use and coronary artery disease on coronary CT angiography diminished (p = 0.12, 95% CI 0.299-1.15). A majority of marijuana users were younger than nonusers and had a lower frequency of hypertension and diabetes than nonusers. There was no statistical difference in lipid panel values between the two groups. Only 2 out of 10 marijuana users with coronary artery disease on coronary CT angiography had hemodynamically significant stenosis. Conclusion Among younger patients being evaluated for chest pain, self-reported cannabis use conferred no additional risk of coronary artery disease as detected on coronary CT angiography.

Myocardial ischaemia associated with tetrahydrocannabinol intake in a teenage boy: A case report

“…In addition, decreased end diastolic volume and stroke volume were observed in THC users. 2,3 Marijuana smokers have higher heart rate than control nonsmoking group. This is probably due to the stimulating effect of marijuana on adrenergic receptors.…”

“…THC, which is an active substance in cannabis, affects cardiovascular system by stimulating the activity of sympathetic nervous system, causing tachycardia, an increase in blood pressure and decreased left ventricular EF. In addition, decreased end diastolic volume and stroke volume were observed in THC users 2,3 …”

“…In scientific research and literature, it is gradually emphasised that cannabis use by young healthy people can lead to ischaemic myocardial incidents 2 . Due to the ever‐increasing popularity of this drug in both the USA and Western European countries, numerous cases of post‐marijuana cardiac incidents have been reported 3 . THC, which is an active substance in cannabis, affects cardiovascular system by stimulating the activity of sympathetic nervous system, causing tachycardia, an increase in blood pressure and decreased left ventricular EF.…”

“…Although CTA has excellent negative predictive value for diagnosing coronary artery disease, its poor usefulness to diagnose coronary vasospasm has been described. This is another aspect of THC use that requires further investigation 3 …”

Modeling the diagnosis of coronary artery disease by discriminant analysis and logistic regression: a cross-sectional study

“…Illicit drug abuse has been identified as a "risk factor" for an association between Illicit drug abuse and a high risk of coronary artery disease. However, limited research has indicated that this relationship may differ depending on the type of region and the type of drug used in that region [ 57 – 60 ]. Another finding of logistic regression is that BMI is related to coronary artery disease.…”