Rikinkumar S Patel1, Saher H Kamil2, Ramya Bachu3, Archana Adikey4, Virendrasinh Ravat5, Mandeep Kaur6, William E Tankersley1, Hemant Goyal7. 1. Department of Psychiatry, Griffin Memorial Hospital and Oklahoma Department of Mental Health and Substance abuse (ODMHAS), Norman, OK 73071, USA. 2. Department of Psychiatry, Austin State Hospital, Austin, TX 78751, USA. 3. Department of Medicine, Baptist Health Medical Center, North Little Rock, AR 72117, USA. 4. Department of Psychiatry, Virginia Tech Carilion Clinic, Roanoke, VA 24018, USA. 5. Department of Medicine, Larkin Community Hospital, South Miami, FL 33143, USA. 6. American University of Antigua, Jabberwock Beach Road PO Box W1451 Coolidge, Antigua. 7. Department of Medicine, The Wright Center of Graduate Medical Education, Scranton, PA 18503, USA. Electronic address: doc.hemant@yahoo.com.
Abstract
BACKGROUND AND OBJECTIVE: Marijuana use has gained popularity following legalization in the US. Marijuana can affect the heart through various mechanisms. This study aims to conduct a systematic review of published case reports of individuals with acute myocardial infarction (AMI) following marijuana use. METHODS: We conducted a systematic review of literature, including case reports, case series, and the letter to the editor on MEDLINE. Forty-six studies were included, with a total number of 62 patients with AMI and marijuana use. RESULTS: The mean age was 27.7 (±10.3) years with male predominance. About 3.7 g marijuana was used for an average of 9.7 years by the patients. From the cases reporting the onset of AMI symptoms, the average time was within 5 h after last marijuana use. The angiographic findings were normal in 36.8% of cases. In 42.1% of individuals, the left anterior descending coronary artery was occluded, making it the most common artery involved, followed by the right coronary artery (10.5%). Most cases were managed medically, followed by thrombectomy and stent placement, and percutaneous transluminal coronary angioplasty (PTCA). Complications included cardio-embolic stroke, and seven deaths were reported. CONCLUSION: It is important to consider episodic marijuana use as a significant risk factor of AMI, particularly in individuals with no cardiac risk factors, as delay in management can result in fatal outcomes including increased risk of mortality.
BACKGROUND AND OBJECTIVE:Marijuana use has gained popularity following legalization in the US. Marijuana can affect the heart through various mechanisms. This study aims to conduct a systematic review of published case reports of individuals with acute myocardial infarction (AMI) following marijuana use. METHODS: We conducted a systematic review of literature, including case reports, case series, and the letter to the editor on MEDLINE. Forty-six studies were included, with a total number of 62 patients with AMI and marijuana use. RESULTS: The mean age was 27.7 (±10.3) years with male predominance. About 3.7 g marijuana was used for an average of 9.7 years by the patients. From the cases reporting the onset of AMI symptoms, the average time was within 5 h after last marijuana use. The angiographic findings were normal in 36.8% of cases. In 42.1% of individuals, the left anterior descending coronary artery was occluded, making it the most common artery involved, followed by the right coronary artery (10.5%). Most cases were managed medically, followed by thrombectomy and stent placement, and percutaneous transluminal coronary angioplasty (PTCA). Complications included cardio-embolic stroke, and seven deaths were reported. CONCLUSION: It is important to consider episodicmarijuana use as a significant risk factor of AMI, particularly in individuals with no cardiac risk factors, as delay in management can result in fatal outcomes including increased risk of mortality.
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