Marijuana Use May Up ACS Risk in Younger Adults

Significant increase in ACS incidence within the 18–36 year old group
Significant increase in ACS incidence within the 18–36 year old group

WASHINGTON, DC—Recreational marijuana use does not appear to increase the risk of acute coronary syndrome (ACS) in adults aged 37–54 years, but a significant increase was seen in those aged 18–36 years who typically have the lowest cardiac risk factors and the highest prevalence of marijuana use, reported researchers at the ACC.17 Scientific Session.

Marijuana use is growing especially among young adults but its cardiovascular effects "remain mostly unknown," said lead author Maryam Afshar, from Bronx Lebanon Hospital Center, Bronx, NY. Afshar and colleagues performed a retrospective observational study (n=14,490) in patients admitted to their hospital between 2012–2014 who had urine toxicology testing done for various reasons. 

"Patients who were aged >54 years were excluded to avoid confounding effects of age and CVD risk factors seen in older population," explained Afshar. 

Within the marijuana-positive group (n=3,638), there were 59 patients with ACS; in the marijuana-negative group (n=10,852), there were 195 patients with ACS.

Patients with ACS in the marijuana-positive group were mostly male (61%), African-American (44%), had hypertension (76%), dyslipidemia (44%), and diabetes (44%) with a mean age of 45.3 years. Demographics and CVD risk factors were comparable for both marijuana groups (P>0.05) except for smoking (P=0.015) and cocaine use (P=0.02). 

The study found that the incidence of ACS between the two groups was no different (RR 0.90, 95% CI: 0.67–1.20; P=0.48). "However," Afshar noted, "there was a significant difference in the incidence of ACS in the 18–36 age group (RR 2.84, 95% CI: 1.14–7.07; P=0.01)." In contrast, this significant difference was not observed in the 37–54 age group (RR 1.00, 95% CI: 0.73–1.36; P=0.99). 

Overall marijuana use (odds ratio [OR] 0.93, 95% CI: 0.68–1.25; P=0.65) was not associated with an increased risk of ACS for patients aged <54 years, or for patients aged 37–54 years (OR 1.11, 95% CI: 0.79–1.53; P=0.50). But there was a significant increase in ACS incidence within the 18–36 year old group (OR 5.24, 95% CI: 1.84–16.93; P=0.002).

Afshar concluded, "A larger study of ACS patients within younger patient population would help to corroborate these findings."