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Marijuana: An Underappreciated Risk Factor for Acute Type A Aortic Dissection?
Iam Claire Sarmiento1, Ashley Giammarino2, S Jacob Scheinerman1
1Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, NY.
The Heart Surgery Forum
|February 26, 2021
Summary
Recent marijuana use may increase the risk of acute aortic dissection, particularly in younger individuals with predisposing factors. Early diagnosis is crucial, especially with increasing marijuana consumption.
Area of Science:
- Cardiology
- Toxicology
- Vascular Surgery
Background:
- Stimulants like cocaine and amphetamines are known risk factors for acute aortic dissection.
- The association between marijuana use and acute aortic syndromes remains understudied despite its prevalence.
Purpose of the Study:
- To investigate the relationship between tetrahydrocannabinol (THC) use and acute Stanford type A aortic dissection.
- To compare the characteristics and outcomes of patients with and without recent marijuana consumption.
Main Methods:
- Retrospective review of 152 patients with Stanford type A aortic dissection (January 2017 - December 2019).
- Urine toxicology screening performed on 51 patients.
- Comparison of patients testing positive for THC (n=9) versus those without recent marijuana use (n=42).
Main Results:
- 17.6% of screened patients tested positive for THC, a higher proportion than expected.
- THC-positive patients were significantly younger (mean age 48 vs. 61.4 years) and had a higher rate of prior aortic aneurysm diagnosis (44.4% vs. 4.8%).
- Thirty-day mortality was 11.1% in the THC group versus 19.6% overall, with no significant difference in postoperative complications.
Conclusions:
- Marijuana use may be a contributing risk factor for acute type A aortic dissection, especially in younger patients with other risk factors.
- Earlier consideration of aortic dissection is recommended for younger patients with suggestive symptoms and a history of marijuana use.
- Increased marijuana consumption due to legalization trends warrants further research into its cardiovascular risks.
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