Abstract 444: Association Between Cannabis Use and Acute Myocardial Infarction

2017 ◽  
Vol 121 (suppl_1) ◽  
Author(s):  
Samson Alliu ◽  
Olaoluwatomi Lamikanra ◽  
Adeyinka Adejumo ◽  
Oluwole Adegbala ◽  
Akintunde Akinjero ◽  
...  

Background: Cannabidiol (CBD)-a component of cannabis with no psychoactive or cognitive effect has been proven in animal models to have a vasodilatory, anti-oxidant and anti-inflammatory effect on the blood vessels. However, it is unclear if cannabis users - while being exposed to its CBD constituents - benefit from its vasodilatory and anti-inflammatory effect in the prevention of acute myocardial infarction (MI). Objective: To investigate if there is a difference in the odds of MI among cannabis users when compared to nonusers. Methods: We used data from the Nationwide Inpatient Sample on patients ages 45 years and older admitted between 2012 - 2014. The main study outcome was clinical diagnosis of MI, and the main exposure variable was cannabis use identified using ICD-9 codes. Cannabis use was categorized into non-use, non-dependent, and dependent use. Multivariable logistic regression models were used to estimate the odds of MI and In-hospital mortality in relation to cannabis use adjusting for demographics, comorbidities, and use of other recreational drugs. Results: Of the 7, 995,162 hospitalized patients who were > 45 years, 532,112 (6.7%) had a diagnosis of MI, 56,836 (0.7%) were non-dependent cannabis user and 5,417 (0.1%) were dependent cannabis users. We observed a significant inverse association between cannabis use and MI (non-dependent OR: 0.86, 95% CI: 0.83-0.90; dependent OR 0.26, 95% CI: 0.21-0.31). After adjusting for confounding variables, the association was attenuated for non-dependent cannabis users (OR: 1.03, 95% CI: 0.99-1.06]). However, among dependent cannabis users, there was 66% decreased odds of MI when compared to nonusers. Also, cannabis use was associated with 32% decreased odds of in-hospital mortality among patients with MI when compared to nonuse. Conclusions: Using the largest national data, our study showed cannabis use was not a risk factor for MI and alternatively may point to a protective benefit in the diagnosis of MI and in-hospital mortality. Future prospective studies may aid in further exploring this association to maximize the therapeutic advantage of the cannabinoid system in MI prevention.

2003 ◽  
Vol 92 (3) ◽  
pp. 298-301 ◽  
Author(s):  
Luis C.L. Correia ◽  
Andrei C. Spósito ◽  
José C. Lima ◽  
Luiz P. Magalhães ◽  
Luiz C.S. Passos ◽  
...  

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Mori ◽  
K Nishihara ◽  
S Honda ◽  
S Kojima ◽  
M Takegami ◽  
...  

Abstract Background Hypertension, diabetes, dyslipidemia and smoking are so-called coronary risk factors for coronary heart disease, which were established by extensive epidemiological research. However, in Japanese patients with acute myocardial infarction (AMI), the impact of number of coronary risk factors on in-hospital morality has not been elucidated. Methods The Japan Acute Myocardial Infarction Registry (JAMIR) is a nationwide real-world database integrated form 10 regional registries. We examined the association between number of coronary risk factors and in-hospital mortality from this JAMIR registry. Results The data were obtained from total of 20462 AMI patients (mean age, 68.8±13.3 years old; 15281 men, 5181 women). Figure 1 shows the prevalence of each coronary risk factors stratified by sex and decade. The prevalence of hypertension became higher with the advanced age while the prevalence of smoking became lower with the advanced age. Prevalence of diabetes and dyslipidemia were highest in middle age. Majority (76.9%) of the patients with AMI had at least 1 of these coronary risk factors and, 23.1% had none of them. Overall, except women under 50, number of coronary risk factor was relatively less in older age (Figure 2). In-hospital mortality by sex and decades was shown in figure 3. In-hospital mortality rates were 10.7%, 10.5%, 7.2%, 5.0% and 4.5% with 0, 1, 2, 3 and 4 risk factors, respectively (Figure 4A). After adjusting age and sex, there was an inverse association between the number of coronary risk factors and in-hospital mortality (adjusted odds ratio [1.68; 95% CI, 1.20–2.35] among individuals with 0 vs. 4 risk factors, Figure 4B). Conclusion In the present study of Japanese patients with AMI, who received modern medical treatment, in-hospital mortality was inversely related to the number of coronary risk factors. Acknowledgement/Funding Grant-in-Aid for Scientific Research


2000 ◽  
Vol 55 (6) ◽  
pp. 357-366 ◽  
Author(s):  
Guy DE GEVIGNEY ◽  
René ECOCHARD ◽  
Cyrille COLLIN ◽  
Muriel RABILLOUD ◽  
Danièle CAO ◽  
...  

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Fu ◽  
C.X Song ◽  
X.D Li ◽  
Y.J Yang

Abstract Background The benefit of statins in secondary prevention of patients stabilized after acute coronary syndrome (ACS) has been well established. However, the benefit of preloading statins, i.e. high-intensity statins prior to reperfusion therapy remains unclear. Most previous studies included all types of ACS patients, and subgroup analysis indicated the benefit of preloading statins was only seen in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, the sample size of subgroup population was relatively small and such benefit requires further validation. Objective To investigate the effect of loading dose of statins before primary reperfusion on 30-mortality in patients with STEMI. Methods We enrolled patients in China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014. CAMI registry was a prospective multicenter registry of patients with acute acute myocardial infarction in China. Patients were divided into two groups according to statins usage: preloading group and control group. Patients in preloading group received loading does of statins before primary reperfusion and during hospitalization. Patients in control group did not receive statins during hospitalization or at discharge. Primary outcome was in-hospital mortality. Baseline characteristics, angiographic characteristics and outcome were compared between groups. Propensity score (PS) matching was used to mitigate baseline differences between groups and examine the association between preloading statins on in-hospital mortality risk. The following variables were used to establish PS matching score: age, sex, classification of hospitals, clinical presentation (heart failure at presentation, cardiac shock, cardiac arrest, Killip classification), hypertension, diabetes, prior angina, prior myocardial infarction history, prior stroke, initial treatment. Results A total of 1169 patients were enrolled in control group and 6795 in preloading group. A total of 833 patients (334 in control group and 499 in preloading group) died during hospitalization. Compared with control group, preloading group were younger, more likely to be male and present with Killip I classification. The proportion of hypertension and diabetes were higher in preloading group. After PS matching, all the variables used to generate PS score were well balanced. In the PS-matched cohort, 30-day mortality risk was 26.3% (292/1112) in the control group and 11.9% (132/1112) in the preloading group (p<0.0001). Conclusions The current study found preloading statins treatment prior to reperfusion therapy reduced in-hospital mortality risk in a large-scale contemporary cohort of patients with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chao-Lun Lai ◽  
Raymond Nien-Chen Kuo ◽  
Ting-Chuan Wang ◽  
K. Arnold Chan

Abstract Background Several studies have found a so-called weekend effect that patients admitted at the weekends had worse clinical outcomes than patients admitted at the weekdays. We performed this retrospective cohort study to explore the weekend effect in four major cardiovascular emergencies in Taiwan. Methods The Taiwan National Health Insurance (NHI) claims database between 2005 and 2015 was used. We extracted 3811 incident cases of ruptured aortic aneurysm, 184,769 incident cases of acute myocardial infarction, 492,127 incident cases of ischemic stroke, and 15,033 incident cases of pulmonary embolism from 9,529,049 patients having at least one record of hospitalization in the NHI claims database within 2006 ~ 2014. Patients were classified as weekends or weekdays admission groups. Dates of in-hospital mortality and one-year mortality were obtained from the Taiwan National Death Registry. Results We found no difference in in-hospital mortality between weekend group and weekday group in patients with ruptured aortic aneurysm (45.4% vs 45.3%, adjusted odds ratio [OR] 1.01, 95% confidence interval [CI] 0.87–1.17, p = 0.93), patients with acute myocardial infarction (15.8% vs 16.2%, adjusted OR 0.98, 95% CI 0.95–1.00, p = 0.10), patients with ischemic stroke (4.1% vs 4.2%, adjusted OR 0.99, 95% CI 0.96–1.03, p = 0.71), and patients with pulmonary embolism (14.6% vs 14.6%, adjusted OR 1.02, 95% CI 0.92–1.15, p = 0.66). The results remained for 1 year in all the four major cardiovascular emergencies. Conclusions We found no difference in either short-term or long-term mortality between patients admitted on weekends and patients admitted on weekdays in four major cardiovascular emergencies in Taiwan.


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