Acute Myocardial Infarction in a Young Man; Fatal Blow of the Marijuana: A Case Report

Yurtdaş, Mustafa; Aydın, Mehmet Kasım

doi:10.4070/kcj.2012.42.9.641

Cited by 29 publications

(12 citation statements)

References 15 publications

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“…Our study showed that AMI with marijuana group consisted more of younger, male (76.9% vs. 66.0%), African American (33.0% vs. 13.8%) patients compared to the non-marijuana group. The same result has been documented previously [ 2 , 9 ]. The higher weekend admissions in AMI-marijuana users could be related to recreational substance use more during weekends leading to higher AMI during the same time.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States

Desai¹,

Patel²,

Sharma³

et al. 2017

Cureus

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BackgroundMarijuana is a widely used recreational substance. Few cases have been reported of acute myocardial infarction following marijuana use. To our knowledge, this is the first ever study analyzing the lifetime odds of acute myocardial infarction (AMI) with marijuana use and the outcomes in AMI patients with versus without marijuana use.MethodsWe queried the 2010-2014 National Inpatient Sample (NIS) database for 11-70-year-old AMI patients. Pearson Chi-square test for categorical variables and Student T-test for continuous variables were used to compare the baseline demographic and hospital characteristics between two groups (without vs. with marijuana) of AMI patients. The univariate and multivariate analyses were used to assess and compare the clinical outcomes between two groups. We used Cochran–Armitage test to measure the trends. All statistical analyses were executed by IBM SPSS Statistics 22.0 (IBM Corp., Armonk, NY). We used weighted data to produce national estimates in our study.ResultsOut of 2,451,933 weighted hospitalized AMI patients, 35,771 patients with a history of marijuana and 2,416,162 patients without a history of marijuana use were identified. The AMI-marijuana group consisted more of younger, male, African American patients. The length of stay and mortality rate were lower in the AMI-marijuana group with more patients being discharged against medical advice. Multivariable analysis showed that marijuana use was a significant risk factor for AMI development when adjusted for age, sex, race (adjusted OR 1.079, 95% CI 1.065-1.093, p<0.001); adjusted for age, female, race, smoking, cocaine abuse (adjusted OR 1.041, 95% CI 1.027-1.054, p<0.001); and also when adjusted for age, female, race, payer status, smoking, cocaine abuse, amphetamine abuse and alcohol abuse (adjusted OR: 1.031, 95% CI: 1.018-1.045, p<0.001). Complications such as respiratory failure (OR 18.9, CI 15.6-23.0, p<0.001), cerebrovascular disease (OR 9.0, CI 7.0-11.7, p<0.001), cardiogenic shock (OR 6.0, CI 4.9-7.4, p<0.001), septicemia (OR 1.8, CI 1.5–2.2, p<0.001), and dysrhythmia (OR 1.8, CI 1.5-2.1, p<0.001) were independent predictors of mortality in AMI-marijuana group.ConclusionThe lifetime AMI odds were increased in recreational marijuana users. Overall odds of mortality were not increased significantly in AMI-marijuana group. However, marijuana users showed higher trends of AMI prevalence and related mortality from 2010-2014. It is crucial to assess cardiovascular effects related to marijuana overuse and educate patients for the same.

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Section: Discussionsupporting

confidence: 92%

“…The previous study has also shown that risk of AMI is amplified in the individuals who smoke marijuana [ 4 ]. There were 13 cases of chest pain and MI which were associated with marijuana smoking [ 9 ]. However, the previous studies had the small sample size and did not take the confounding factors into account in the results.…”

Section: Discussionmentioning

confidence: 99%

Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States

Desai¹,

Patel²,

Sharma³

et al. 2017

Cureus

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“…Reported cardiovascular effects linked to cannabis include anecdotal cases of acute coronary syndrome, congestive heart failure, and arrhythmias (56, 97, 130, 133–136). Patients with angina may have decreased time with chest pain onset due to the acute effects of cannabis use; also, myocardial infarction may be triggered by the acute effects of cannabis use (56).…”

Section: Medical Adverse Effectsmentioning

confidence: 99%

Marijuana: Current Concepts†

Greydanus¹,

Hawver²,

Greydanus³

et al. 2013

Front. Public Health

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Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the twenty-first century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public that is often confused by a media-driven, though false message and promise of benign pot consumption.

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“…Additionally, review articles refer to the first hour after cannabis smoking as the riskiest hour, with the risk falling rapidly thereafter . Several authors have reported cases of CVD in proximity to cannabis use, sometimes supported by a positive urinalysis, as reported in Table . However, a positive cannabis finding is common up to 5 days after smoking and, in heavy smokers, positivity may be present for weeks or months .…”

Section: Introductionmentioning

confidence: 99%

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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Acute Myocardial Infarction in a Young Man; Fatal Blow of the Marijuana: A Case Report

Cited by 29 publications

References 15 publications

Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States

Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States

Marijuana: Current Concepts†

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

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