Myocardial infarction

In MI, Marijuana Use Raises Mortality Risk

Use of cocaine and/or marijuana is associated with increased risks for cardiovascular and all-cause mortality among patients with myocardial infarction (MI), according to new findings.

Researchers arrived at this conclusion following a study of 2097 patients aged 50 years and younger with type 1 MI at 2 academic hospitals from 2000 to 2016. Median follow-up lasted 11.2 years.
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Patient-reported substance abuse during the week prior to MI or substance detection on toxicology screen were used to determine substance abuse status. The Social Security Administration’s Death Master File was used to identify vital status.

In addition, electronic health records and death certificates were used to adjudicate cause of death, and survival free from all-cause and cardiovascular mortality was assessed via Cox modeling.

Approximately 99 patients (4.7%) had used cocaine, and 125 (6.0%) had used marijuana. Results of the study showed that individuals with substance use:

  • Had significantly lower rates of diabetes (14.7% vs 20.4%) and hyperlipidemia (45.7% vs 60.8%) compared with those without substance use.
  • Were significantly more likely to use tobacco (70.3% vs 49.1%)
  • Had a significantly higher risk for cardiovascular mortality (hazard ratio [HR] 2.22) and all-cause mortality (HR 1.99) following adjustment for baseline covariates.

“Cocaine and/or marijuana use is present in 10% of patients with an MI at age [50 years and younger] and is associated with worse all-cause and cardiovascular mortality,” the researchers wrote.

“These findings reinforce current recommendations for substance use screening among young adults with an MI, and they highlight the need for counseling to prevent future adverse events,” they concluded.

—Christina Vogt

Reference:

DeFilippis EM, Singh A, Divakaran S, et al. Cocaine and marijuana use among young adults with myocardial infarction. J Am Coll Cardiol. 2018;71(22). doi:10.1016/j.jacc.2018.02.047