Relation of Cannabis Use and Atrial Fibrillation Among Patients Hospitalized for Heart Failure

Adegbala, Oluwole; Adejumo, Adeyinka Charles; Olagoke, Olakanmi; Akinjero, Akintunde; Akintoye, Emmanuel; Alliu, Samson; Edo-Osagie, Eseosa; Chatterjee, Arka

doi:10.1016/j.amjcard.2018.03.015

Cited by 23 publications

(11 citation statements)

References 34 publications

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“…The observed cardiovascular benefits of MC outlined here in this case support current trends in the literature, i.e. cell culture [5], systematic reviews [6], receptor cloning and agonist/antagonist studies [7][8][9]. The case also supports the hypothesis that components of cannabis appear to be cardioprotective [4][5][6][7][8][9], operating via a vast distribution of the endocannabinoid system (ECS) and non-cannabinoid secondary messenger systems.…”

Section: Discussionsupporting

confidence: 77%

Case Report - Unstable Angina, Coronary Artery Disease, and Cannabis

Entler¹,

Shaffer²,

Davis³

et al. 2020

Preprint

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Rationale:First discovered in 1990, the endocannabinoid system (ECS) was initially shown to have an intimate relationship with central areas of the nervous system associated with pain, reward, and motivation. Recently, however, the ECS has been extensively implicated in the cardiovascular system with contractility, heart rate, blood pressure, and vasodilation. Emerging data demonstrates modulation of the ECS plays an essential role in cardio metabolic risk, atherosclerosis, and can even limit damage to cardiomyocytes during ischemic events.Patient Concerns:This case describes a 63-year-old male who presented to a primary care physician for a medical cannabis (MC) consult due to unstable angina (UA) not relieved by morphine or cardiac medications; having failed all first- and second-line poly-pharmaceutical therapies. The patient reported frequent, unprovoked, angina and exertional dyspnea.Diagnosis:Having a complex cardiac history, the patient first presented 22 years ago after a suspected myocardial infarction (MI). He re-presented in 2010 and underwent stent placement at that time for inoperable triple-vessel coronary artery disease (CAD) which was identified via percutaneous transluminal coronary angioplasty. UA developed on follow up and, despite medical management over the past 6 years, his UA became progressively debilitating.Interventions and Outcomes:In conjunction with his standard cardiac care, patient had a gradual lessening of UA related pain, including frequency and character, after using an edible form of medical cannabis (MC) (1:1 CBD:THC). Following continued treatment, he ceased long term morphine treatment and describes the pain as no longer crippling. As demonstrated by his exercise tolerance tests, the patient experienced an improved functional capacity and reported an increase in his daily functioning, and overall activity.Lessons:This case uniquely highlights MC in possibly reducing the character, quality, and frequency of UA; while concordantly improving functional cardiac capacity in a patient with CAD. Additional case reports are necessary to verify this.

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Section: Discussionsupporting

confidence: 77%

Case Report - Unstable Angina, Coronary Artery Disease, and Cannabis

Entler¹,

Shaffer²,

Davis³

et al. 2020

Preprint

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“…In this cohort, the use of MJ showed no impact on survival at 1 and 5 years post‐transplant . A more recent study of almost 4 million non‐transplant patients admitted with heart failure and atrial fibrillation showed that only 0.45% described cannabis use, indicating a lower odds of atrial fibrillation in marijuana users …”

Section: Resultsmentioning

confidence: 63%

Marijuana use in transplantation: A call for clarity

Levi¹,

Montague²,

Thurstone

et al. 2019

Clinical Transplantation

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Transplant centers have varying policies for marijuana (MJ) use in donors, transplant candidates, and recipients. Rationales for these differences range from concerns for fungal complications, impaired adherence, and drug interactions. This paper reviews the current status of MJ policies and practices in transplant centers and results of a survey sent to the American Society of Transplantation (AST) membership by the Executive Committee of the AST Infectious Diseases Community of Practice. The purpose of the survey was to compare policies and concerns of MJ use to actual observed complications. Of the 3321 surveys sent, 225 members (8%) responded. Transplant centers varied in their approval processes, differing even in organ types within the same institutions. Furthermore, there was discordance among transplant centers in their perceived risks of marijuana use as opposed to complications actually observed. An increasing number of states continue to legalize medical and recreational MJ resulting in widespread availability. Further research is needed to assess the validity of concerns for complications of MJ use in potential donors and recipients. Ultimately, standardized guidelines should be established based on studies and evidence-based criteria to assist transplant programs in their policies around the use of cannabis in their donors and recipients.

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“…More recently, Latif et al[17] indicated that higher UA levels are associated with lower all-cause and cardiovascular mortality, however, they included only hemodialysis patients. Similarly, another study using the NIS suggested that co-occurring gout is associated with reduced in-hospital mortality among postmeno-pausal women admitted for AMI[18]. The paradoxical association with mortality could be due to focus on the short-term post-revascularization in-hospital outcomes, residual confounding factors in administrative data, or missed diagnosis in patients without gout.…”

Section: Discussionmentioning

confidence: 99%

Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample

Desai

Parekh

Goyal

et al. 2019

WJC

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BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate. AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality. METHODS We used the national inpatient sample (2010-2014) to identify the ACS and gout-related hospitalizations, relevant comorbidities, revascularization and post-revascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality. RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACS-gout cohort ( P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17-1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization ( P < 0.001). Odds of post-revascularization in-hospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white ( P < 0.001). However, post-operative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort. CONCLUSION Although gout was not independently associated with an increased risk of post-revascularization in-hospital mortality in ACS, it did increase post-revascularization complications.

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Relation of Cannabis Use and Atrial Fibrillation Among Patients Hospitalized for Heart Failure

Cited by 23 publications

References 34 publications

Case Report - Unstable Angina, Coronary Artery Disease, and Cannabis

Case Report - Unstable Angina, Coronary Artery Disease, and Cannabis

Marijuana use in transplantation: A call for clarity

Impact of gout on in-hospital outcomes of acute coronary syndrome-related hospitalizations and revascularizations: Insights from the national inpatient sample

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