Triggering Myocardial Infarction by Marijuana

Author:

Mittleman Murray A.1,Lewis Rebecca A.1,Maclure Malcolm1,Sherwood Jane B.1,Muller James E.1

Affiliation:

1. From the Institute for the Prevention of Cardiovascular Disease, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School (M.A.M., R.A.L.); the Department of Epidemiology (M.A.M., M.M.) and the Department of Health and Social Behavior (J.B.S.), Harvard School of Public Health; and the Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School (J.E.M.), Boston, Mass.

Abstract

Background —Marijuana use in the age group prone to coronary artery disease is higher than it was in the past. Smoking marijuana is known to have hemodynamic consequences, including a dose-dependent increase in heart rate, supine hypertension, and postural hypotension; however, whether it can trigger the onset of myocardial infarction is unknown. Methods and Results —In the Determinants of Myocardial Infarction Onset Study, we interviewed 3882 patients (1258 women) with acute myocardial infarction an average of 4 days after infarction onset. We used the case-crossover study design to compare the reported use of marijuana in the hour preceding symptoms of myocardial infarction onset to its expected frequency using self-matched control data. Of the 3882 patients, 124 (3.2%) reported smoking marijuana in the prior year, 37 within 24 hours and 9 within 1 hour of myocardial infarction symptoms. Compared with nonusers, marijuana users were more likely to be men (94% versus 67%, P <0.001), current cigarette smokers (68% versus 32%, P <0.001), and obese (43% versus 32%, P =0.008). They were less likely to have a history of angina (12% versus 25%, P <0.001) or hypertension (30% versus 44%, P =0.002). The risk of myocardial infarction onset was elevated 4.8 times over baseline (95% confidence interval, 2.4 to 9.5) in the 60 minutes after marijuana use. The elevated risk rapidly decreased thereafter. Conclusions —Smoking marijuana is a rare trigger of acute myocardial infarction. Understanding the mechanism through which marijuana causes infarction may provide insight into the triggering of myocardial infarction by this and other, more common stressors.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Reference35 articles.

1. Substance Abuse and Mental Health Services Administration. National Household Survey on Drug Abuse . Rockville Md: SAMHSA Office of Applied Sciences; 1998. DHHS No. (SMA)99–3328 1999.

2. Marihuana: Standardized Smoke Administration and Dose Effect Curves on Heart Rate in Humans

3. Effect of Marihuana and Placebo-Marihuana Smoking on Angina Pectoris

4. Cardiovascular Effects of Marihuana in Man

Cited by 511 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3