Cannabis Use Variations and Myocardial Infarction: A Systematic Review

Area of Science:

• Cardiovascular Disease Epidemiology
• Cannabis and Public Health
• Toxicology of Smoke Inhalation

Background:

• Cannabis use is linked to increased coronary heart disease (CHD), including myocardial infarction (MI) and angina pectoris (AP).
• The independent risk of cannabis use for MI is unclear due to frequent co-use with tobacco.
• Investigating the specific risks associated with different cannabis consumption methods (smoking, vaping, edibles) is crucial.

Purpose of the Study:

• To determine if cannabis is an independent risk factor for myocardial infarction (MI).
• To compare the cardiovascular risk of MI across different cannabis consumption methods: smoking, vaping, and edibles.
• To assess the impact of concurrent tobacco use on cannabis-related MI risk.

Main Methods:

• Systematic review conducted following PRISMA guidelines.
• Searches performed across Medline (PubMed), Embase, and Google Scholar databases.
• Analysis of 22 eligible studies to evaluate associations between cannabis use and MI.

Main Results:

• Cannabis smoking showed a significant association with MI (aORs 1.03–5.24) even after adjusting for tobacco use.
• Frequent cannabis smoking posed a significant MI risk (aOR = 1.88) even in individuals who never used tobacco.
• Cannabis vaping and ingestion (non-smoking forms) were not significantly associated with increased cardiovascular risk (frequent use: aOR = 1.00 ns; current use: aOR = 1.31 ns).

Conclusions:

• Cannabis smoking may independently trigger myocardial infarction (MI), similar to tobacco smoking.
• Non-combustible cannabis consumption methods like vaping and ingestion appear less harmful.
• Reduced harm from vaping/ingestion likely stems from avoiding toxins present in cannabis smoke, such as carbon monoxide.