Department of Radiology & Radiological Sciences, Medical University of South Carolina, Charleston, South Carolina, United States of America.
Department of Internal Medicine, McGovern Medical School at University of Texas - Houston, Houston, Texas, United States of America.
PLoS One. 2020 Jan 29;15(1):e0228326. doi: 10.1371/journal.pone.0228326. eCollection 2020.
Marijuana is the most popular drug of abuse in the United States. The association between its use and coronary artery disease has not yet been fully elucidated. This study aims to determine the frequency of coronary artery disease among young to middle aged adults presenting with chest pain who currently use marijuana as compared to nonusers.
In this retrospective study, 1,420 patients with chest pain or angina equivalent were studied. Only men between 18 and 40 years and women between 18 and 50 years of age without history of cardiac disease were included. All patients were queried about current or prior cannabis use and underwent coronary CT angiography. Each coronary artery on coronary CT angiography was assessed based on the CAD-RADS reporting system.
A total of 146 (10.3%) out of 1,420 patients with chest pain were identified as marijuana users. Only 6.8% of the 146 marijuana users had evidence of coronary artery disease on coronary CT angiography. In comparison, the rate was 15.0% among the 1,274 marijuana nonusers (p = 0.008). After accounting for other cardiac risk factors in a multivariate analysis, the negative association between marijuana use and coronary artery disease on coronary CT angiography diminished (p = 0.12, 95% CI 0.299-1.15). A majority of marijuana users were younger than nonusers and had a lower frequency of hypertension and diabetes than nonusers. There was no statistical difference in lipid panel values between the two groups. Only 2 out of 10 marijuana users with coronary artery disease on coronary CT angiography had hemodynamically significant stenosis.
Among younger patients being evaluated for chest pain, self-reported cannabis use conferred no additional risk of coronary artery disease as detected on coronary CT angiography.
大麻是美国最受欢迎的滥用药物。其与冠状动脉疾病之间的关联尚未完全阐明。本研究旨在确定目前使用大麻与非使用者相比，出现胸痛的年轻至中年成年人中冠状动脉疾病的频率。
在这项回顾性研究中，研究了 1420 名胸痛或等效心绞痛患者。仅包括无心脏病史的 18 至 40 岁男性和 18 至 50 岁女性。所有患者均被询问当前或既往大麻使用情况，并接受了冠状动脉 CT 血管造影。根据 CAD-RADS 报告系统评估冠状动脉 CT 血管造影上的每根冠状动脉。
在 1420 名胸痛患者中，共有 146 名（10.3%）被确定为大麻使用者。在冠状动脉 CT 血管造影上，仅有 6.8%的 146 名大麻使用者有冠状动脉疾病的证据。相比之下，在 1274 名非大麻使用者中，该比率为 15.0%（p=0.008）。在多变量分析中考虑其他心脏危险因素后，大麻使用与冠状动脉 CT 血管造影上冠状动脉疾病之间的负相关减弱（p=0.12，95%CI 0.299-1.15）。大多数大麻使用者比非使用者年轻，高血压和糖尿病的频率低于非使用者。两组之间的血脂谱值无统计学差异。在冠状动脉 CT 血管造影上有冠状动脉疾病的 10 名大麻使用者中，只有 2 名存在血流动力学意义上的狭窄。
在接受胸痛评估的年轻患者中，自我报告的大麻使用并不能增加冠状动脉 CT 血管造影上检测到的冠状动脉疾病的风险。
