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

Abstract

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.

Marijuana medusa: The many pulmonary faces of marijuana inhalation in adolescent males

“…Acute respiratory failure is a common complication of inhalation drug abuse, most commonly from cocaine and amphetamines abuse . An increasing number of cases of respiratory failure from marijuana abuse have been reported in adults . The most common pulmonary injuries from marijuana inhalation are bronchospasm, pneumothorax, and aspergillus infection from contaminated inhalants .…”

“…9,10 An increasing number of cases of respiratory failure from marijuana abuse have been reported in adults. [11][12][13][14][15][16][17][18] The most common pulmonary injuries from marijuana inhalation are bronchospasm, pneumothorax, and aspergillus infection from contaminated inhalants. 9,19,20 Though rare, reports of tainted forms of marijuana, referred to as "smoking wet" or "fry," leading to respiratory failure requiring extracorporeal membrane oxygenation (ECMO), have been reported.…”

Rising Trends in Medication Non-compliance and Associated Worsening Cardiovascular and Cerebrovascular Outcomes Among Hospitalized Adults Across the United States

“…We evaluated the frequency of various CCE which included first or subsequent myocardial infarction (MI), first or subsequent stroke, out of hospital cardiac arrest, arrhythmias, and venous thromboembolism (Appendix). The details of NIS data on variables, demographics, hospital-level characteristics, and comorbidities have been published previously [11][12][13]. We examined and compared the following baseline variables between the two groups: demographics, the source of payer and median household income quartile for patients' zip code, hospital-related variables, and preexisting comorbidities.…”

The Road towards the Responsible and Safe Legalization of Cannabis Use in Portugal

“…3 Passemos, então, a uma descrição detalhada dos impactos agudos e crónicos conhecidos do uso de cannabis na saúde dos seus consumidores. 4,6,7 • A toxicidade da cannabis é muito baixa e não há risco de overdose estabelecido.…”

“…20,21 • Risco da dependência: Sugere-se que cerca de um em cada 11 utilizadores se torna consumidor sistemático de cannabis. 22,23 Este número aumenta entre aqueles que começam na adolescência (até cerca de 17%, ou um em cada 6) 24 e entre pessoas que usam cannabis diariamente (até 25% -50%).…”