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年轻(18-39 岁)非滥用其他物质的大麻使用者心血管事件住院率上升趋势。

Rising Trends in Hospitalizations for Cardiovascular Events among Young Cannabis Users (18-39 Years) without Other Substance Abuse.

机构信息

Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, GA 30033, USA.

Division of Cardiovascular Medicine, University of California Davis Medical Center, Sacramento, CA 95817, USA.

出版信息

Medicina (Kaunas). 2019 Aug 5;55(8):438. doi: 10.3390/medicina55080438.

Abstract

Modern-day epidemiologic data on the risk and shifting landscape of occurrence of cardiovascular events in cannabis users remain inadequate and rather conflicting, especially amongst the young adult population. Furthermore, the problem of polysubstance use among youth is challenging for healthcare professionals and policy-makers. Previous studies report higher risk of concomitant use of tobacco, alcohol, cocaine, and amphetamine in young cannabis users. However, most of these studies did not eliminate the confounding effects of concomitant other substance abuse while assessing the incidence and outcome of cardiovascular events in cannabis users. Using weighted discharge records from the National Inpatient Sample (NIS) from 2007-2014, we assessed the national trends in hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users (18-39 years), excluding cases with concomitant substance abuse with alcohol, tobacco, cocaine, and amphetamine. Of 52.3 million hospitalizations without other substance abuse, 0.7 million (1.3%) young adults were current/former cannabis users. Among young adults without concomitant substance abuse, the frequency of admissions for AMI (0.23% vs. 0.14%), arrhythmia (4.02% vs. 2.84%), and stroke (0.33% vs. 0.26%) was higher in cannabis users as compared to non-users ( < 0.001). However, the frequency of admissions for VTE (0.53% vs. 0.84%) was lower among cannabis users as compared non-users. Between 2007 and 2014, we observed 50%, 79%, 300%, and 75% relative increases in hospitalizations for AMI, arrhythmias, stroke, and VTE, respectively, among young cannabis users as compared to non-users, showing relatively inferior or no ascent in the rates ( < 0.001). The rising trends in hospitalizations for acute cardiovascular events among young cannabis users without concomitant other substance abuse call for future prospective well-designed studies to assess cannabis-related short-and long-term cardiovascular implications while simultaneously developing focused interventions towards raising awareness among the young population regarding the potential deleterious effects of cannabis use.

摘要

目前,关于大麻使用者心血管事件风险和发生情况的变化趋势的现代流行病学数据仍然不足且存在较大争议,尤其是在年轻成年人群中。此外,青少年多物质使用问题给医疗保健专业人员和政策制定者带来了挑战。先前的研究报告称,年轻的大麻使用者同时使用烟草、酒精、可卡因和苯丙胺的风险更高。然而,在评估大麻使用者心血管事件的发生率和结果时,大多数这些研究并没有消除同时存在其他物质滥用的混杂影响。

我们利用 2007 年至 2014 年国家住院患者样本(NIS)的加权出院记录,评估了年轻大麻使用者(18-39 岁)中包括急性心肌梗死(AMI)、心律失常、中风和静脉血栓栓塞事件(VTE)在内的主要心血管事件住院率的全国趋势,排除了同时滥用酒精、烟草、可卡因和苯丙胺的病例。

在没有其他物质滥用的 5230 万例住院病例中,有 70 万(1.3%)年轻成年人是当前/曾经的大麻使用者。在没有同时物质滥用的年轻成年人中,与非使用者相比,大麻使用者因 AMI(0.23%比 0.14%)、心律失常(4.02%比 2.84%)和中风(0.33%比 0.26%)的住院频率更高(<0.001)。然而,与非使用者相比,大麻使用者因 VTE(0.53%比 0.84%)的住院频率较低。在 2007 年至 2014 年间,与非使用者相比,我们观察到年轻大麻使用者因 AMI、心律失常、中风和 VTE 的住院率分别增加了 50%、79%、300%和 75%,表明这些比率相对没有上升或上升趋势较慢(<0.001)。

在没有同时存在其他物质滥用的年轻大麻使用者中,急性心血管事件的住院率呈上升趋势,这需要未来进行前瞻性的、设计良好的研究,以评估大麻与短期和长期心血管影响之间的关系,同时针对年轻人群开展提高对大麻使用潜在有害影响的认识的重点干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7509/6723728/54435c834f74/medicina-55-00438-g001.jpg

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