Clinical InvestigationAcute Ischemic Heart DiseaseAn exploratory prospective study of marijuana use and mortality following acute myocardial infarction
Section snippets
Onset Study enrollment and data collection
The Onset Study was conducted in 45 community and tertiary care medical centers. Between August 1989 and September 1994, 1935 patients (601 women and 1334 men) were interviewed a median of 4 days after sustaining a MI. Trained research interviewers identified eligible patients by reviewing coronary care unit admission logs and patient charts. For inclusion, patients were required to have a creatine kinase level above the upper limit of normal for each center, positive MB isoenzymes, an
Patient characteristics
Table I shows the characteristics of the Onset Study participants according to marijuana use. A total of 52 patients (2.7%) reported marijuana use in the preceding year. As expected,5 marijuana users tended to be younger than other patients; had heavier usual alcohol consumption; and were more likely to be male, current smokers, and divorced or separated. Among marijuana users, the reported median frequency of use was once every 2 weeks.
Marijuana use and mortality
A total of 317 patients died during a median of 3.8 years
Discussion
In this preliminary prospective cohort study of early survivors of AMI, marijuana use, as measured at the time of hospitalization, was associated with 3-fold higher mortality after infarction. There was a gradient in risk, with the highest risk of death among individuals who used marijuana most frequently, and the risk was entirely unchanged by multivariate adjustment.
Marijuana use has important cardiovascular effects that could pose risk for patients with coronary heart disease. Among the
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2021, Current Opinion in PsychologyCardiovascular Effects of Medical Marijuana: A Systematic Review
2021, American Journal of MedicineA Literature Review of Cannabis and Myocardial Infarction—What Clinicians May Not Be Aware Of
2021, CJC OpenCitation Excerpt :‘The determinants of MI onset’ (MIOS) database enrolled patients with MI from 45 US hospitals during 1989-1996. Mukamal et al. initially followed these patients for 3.8 years, and they found that there was an increased mortality rate associated with marijuana users compared to nonusers.82 Frost et al.83 then continued this study and followed these patients for a total of 18 years.
Association of Cannabis Use With All-Cause and Cause-Specific Mortality Among Younger- and Middle-Aged U.S. Adults
2020, American Journal of Preventive MedicineCitation Excerpt :However, studies regarding the association of cannabis use with all-cause and cause-specific mortality are sparse, and previous studies have yielded inconsistent results. A total of 2 studies have found that heavy cannabis use was associated with a higher risk of all-cause mortality,5,6 whereas some other studies have found a null association between cannabis use and all-cause or cardiovascular disease (CVD) mortality.7–10 It is worth noting that the interpretation of the findings from these studies is hindered by some study design characteristics, such as different exposure measurements of cannabis, limited participant age range,5,7–10 small sample size,6 or short periods of follow-up.6
This study was supported by grants R01HL41016 from the National Heart, Lung, and Blood Institute, Bethesda, MD; R21AA014900 from the National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD; and 9630115N from the American Heart Association, Dallas, TX, for the Onset Study.