Acute myocardial infarction associated with cannabis use

Background Cannabis is one of the most widely used illicit substances worldwide, and it has the highest prevalence among drugs used in our country in young adults. Yet its potential cardiovascular consequences are not fully understood. Aim of the study Highlighting the demographic, clinical presentation, laboratory results and angiographic characteristics of patients with type 1 myocardial infarction (MI) with a history of cannabis use. Methods Retrospective chart review of patients with MI presenting to our Intensive Coronary Care Unit over a period of 4 years (January 2014–December 2018), and who reported the recent use of cannabis and other substances. No toxicological screen was performed. Results Of the 14 case subjects studied who presented with chest pain, mean age at presentation was 40.1 ± 9.7 (years) SD. There were 13 males and one female. All patients were tobacco smokers, 4 patients (28%) had a history of diabetes and no history of dyslipidemia and hypertension was noted in all patients. All patients used Cannabis (100%), 14% cocaine and 28% alcohol. At presentation, 11 patients (78%) had an EKG evidences of ST-segment elevation MI (STEMI), two of them were transient. Complete atrioventricular block was found in one case. Troponin I (hs cTnI) peak mean level was 13000 ± 23511 ng/ml. All patients underwent coronary angiography and 9 of them had angiographic evidence of single vessel obstructive coronary artery disease. Left ventricular ejection fraction (EF) as determined by cardiac echocardiogram ranged from 15% to 70%, with a mean of 47% ± 15%. Conclusion In our study, Cannabis use is associated with MI, occurring at a relatively younger age with half of the cases either low risk or CVD risk free. Additional studies are needed to further characterize this population given the increase in marijuana use.