A new study has found that about 10% of patients who are 50 years old or younger who suffer from type 1 MI or myocardial infarction use cannabis or cocaine. And these patients, according to the study, showed double the risk of all-cause or cardiovascular death over extended follow-up.
The study was published in the June 2018 issue of the Journal of American College of Cardiology. (You can take a look at the study here.)
MI, which is more commonly known as a heart attack, takes place when blood flow to a part of the heart stops or decreases, causing damage to the heart muscle. Common symptoms of MI include chest pain and discomfort that may travel to the arm, shoulder, neck, back, and/or jaw.
According the study’s senior author, Ron Blankstein, MD, Cocaine has been known as a risk factor for myocardial infraction, but the relationship between cannabis and cardiovascular disease is something that is not as clear.
The researchers wrote that the legalization of cannabis in a growing number of states and the rise in substance use among young adults have led to a public health debate. It also became apparent that there is an urgent need to understand how this substance use affects one’s health.
Therefore, the researchers conducted a study to determine the prevalence of substance abuse among young people with their first MI at less than 50 years of age, as well as its association with cardiovascular outcomes.
Blankstein and his team studied 2,097 patients under 50 years old from two medical centers in Boston, Massachusetts General Hospital and Brigham and Women’s Hospital. The team assessed substance use through self reports by patients or through the detection of substance on toxicology screenings from the week that led up to the MI.
Their findings include the following:
- 10.7% of the patients were found to use cannabis or cocaine, with 6% using cannabis and 4.7% using cocaine, and 1.7% using both drugs.
- Using either cannabis or cocaine is linked to a 2.22-fold risk of cardiovascular mortality over a median 11.3 years of follow-up and a 1.99-fold risk of all-cause mortality. These calculations included adjustments for baseline covariates.
- Individuals who reported substance use had a lower prevalence of high cholesterol and diabetes but had significantly higher rates of tobacco use (70.3% vs. 49.1%).
- When compared to individuals who do not use either substance, the adjusted hazard ratios for all-cause mortality were 1.91 for cocaine and 2.09 for cannabis. The ratios for cardiovascular mortality were 2.32 for cocaine and 2.13 for cannabis.
- 8.8% of patients in the cannabis group suffered out-of-hospital cardiac arrest with the initial MI, while it was 3.5% of non-users. There were no significant differences in OOH cardiac arrest between non-users and cocaine users.
- Mortality rates in the cocaine group were 2.34 deaths per 100 person-years, followed by 1.64 deaths in the cannabis group, and 1.11 deaths among people with no evidence of using either substance.
The researchers said that their findings suggest that there is a need for aggressive interventions for young people to stop the use of cocaine or cannabis. They also emphasize the need for aggressive treatment of all other underlying cardiovascular risk factors among young patients who suffer an MI while actively using cannabis or cocaine.
What’s more, the researchers found that there is an increase in all-cause death among both cannabis and cocaine consumers. The reason for this particular finding may be that young people who use these substances may also take part in other high-risk behaviors that could lead to non-cardiovascular mortality.
Moreover, the researchers noted that there was a 9% average increase in cannabis use each year of the study period, which was from 2000 to 2016, whereas the rate of cocaine use stayed relatively the same within the same period.