Author + information
- Maryam Afshar,
- Niraj Karki,
- Peter Chernek,
- Phyo Thet,
- Binita Sapkota,
- Swosti R. Magar,
- Muhammad Ameen,
- Sridhar Chilimuri and
- Jonathan Bella
Background: Recreational marijuana is now legalized in five states. Its use is rising especially among young adults. The cardiovascular (CVD) effect of marijuana remains mostly unknown.
Methods: This was a retrospective observational study of 14,490 patients admitted to our hospital between 2012-2014 who had urine toxicology done for various reasons. Those >54 years were excluded to avoid confounding effects of age and CVD risk factors seen in older population. Patients with primary diagnosis of Acute Coronary Syndrome (ACS) were queried in both marijuana positive group n= 59 and marijuana negative group n= 195. The incidence of ACS hospitalization was compared in both groups.
Results: In the ACS with (+) marijuana group, the mean age was (45.3 ± 7.8), 61% male, 44% African American, 19% Hispanic, 44% dyslipidemic, 76% hypertensive, 44% diabetic. Demographics and CVD risk factors were similar in both groups with p >0.05 except for smoking (p =0.015) and cocaine use (p= 0.02). The incidence of ACS between the two groups were not different (RR: 0.90, 95% CI: 0.67-1.20, p=0.48). However, there was a significant difference in the incidence of ACS in the 18-36 age group (RR: 2.84, 95% CI: 1.14- 7.07, p= 0.01). While this significant finding was not seen in 37-54 age group (RR: 1.00, 95% CI: 0.73-1.36, p= 0.99). Multivariate analyses were performed after adjusting for the potential effects of smoking and cocaine use. Overall marijuana use (OR: 0.93, 95% CI: 0.68-1.25, p=0.65) was not shown to increase the likelihood of ACS for patients ≤ 54 years, or for those in the 37-54 age group (OR: 1.11, 95% CI=0.79-1.53, p=0.50). However it did show a significant increase in the incidence of ACS within the 18-36 age bracket (OR: 5.24, 95% CI: 1.84- 16.93, p=0.002).
Conclusions: Our findings suggest that overall among patients aged 18-54, recreational marijuana use does not have an independent risk of increasing the likelihood of ACS. However, in younger patients (age 18-36) who usually have the lowest cardiac risk factors and the highest prevalence of marijuana use it seems to be associated with increased likelihood of ACS. A larger study of ACS patients within younger patient population would help to corroborate these findings.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-345
- 2017 American College of Cardiology Foundation