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Recent cannabis use and myocardial infarction in young adults: a cross-sectional study
Karim S Ladha1, Nikhil Mistry1, Duminda N Wijeysundera1
1Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont.
Background:
Cannabis use is increasing among young adults, but its effects on cardiovascular health are poorly understood. We aimed to assess the association between recent cannabis use and history of myocardial infarction (MI) in young adults (aged 18-44 yr).
Methods:
We performed a cross-sectional study using pooled data from the 2017 and 2018 cohorts of the American Behavioral Risk Factor Surveillance System survey of US adults. We analyzed the association between any recent cannabis use and history of MI using a weighted logistic regression model that adjusted for demographic factors, socioeconomic factors, health-related behaviours, concomitant substance use and other comorbidities. We also assessed this association after stratifying by frequency of use and by primary method of consumption.
Results:
Among 33 173 young adults (18.5 million weighted), 4610 respondents (3.2 million weighted) reported recent cannabis use (17.5%, 95% confidence interval [CI] 16.8%-18.2%). A history of MI was more frequent among recent cannabis users (n = 61 of 4610, 1.3%) relative to nonusers (n = 240 of 28 563 [0.8%], adjusted odds ratio [OR] 2.07, 95% CI 1.12-3.82). A history of MI was associated with cannabis use of more than 4 times per month (adjusted OR 2.31, 95% CI 1.18-4.50), and with smoking as a primary method of consumption (adjusted OR 2.01, 95% CI 1.02-3.98).
Interpretation:
Our study provides evidence supporting an association between recent cannabis use and history of MI in young adults. Increasing cannabis use in an at-risk population could have negative implications for cardiovascular health.
