In the Journals

Marijuana use may increase CV complications in young adults

Increased reports of CV complications related to cannabis use suggest that it may be a possible risk factor for CVD in young adults.

Researchers analyzed data from the French Addictovigilance Network, a database of serious cases of abuse and dependence related to psychoactive substances.

From 2006 to 2010, there were 1,979 spontaneous reports of complications related to cannabis use reported. Of those, 35 (1.8%) were CV complications. The cases occurred mostly in men (85.7%) who were younger (mean age, 34 years).

Twenty-two cases involved cardiac complications, including 20 ACS; 10 involved peripheral complications, including lower limb or juvenile arteriopathies; and three involved cerebral complications, including acute cerebral angiopathy, transient cortical blindness and spasm of cerebral artery. Nine cases resulted in death.

Overall, the number of cases of CV complications increased from five (1.1% of cannabis-related reports) in 2006 to 11 (3.6% of cannabis-related reports) in 2010.

“Given that cannabis is perceived to be harmless by the general public and that legalization of its use is debated, data concerning its danger must be widely disseminated,” Emilie Jouanjus, PharmD, of Centre Hospitalier Universitaire de Toulouse in Toulouse, France, and colleagues wrote. “Practitioners should be aware that cannabis may be a potential triggering factor for [CV] complications in young people.”

Robert A. Kloner, MD, PhD, FACC

Robert A. Kloner

In a related editorial, Shereif Rezkalla, MD, FACP, FACC, from Marshfield Clinic, Marshfield, Wis., and Robert A. Kloner, MD, PhD, FACC, from Keck School of Medicine, University of Southern California, noted that “while the concomitant use of other products, such as tobacco and alcohol, may have contributed to some of these events, approximately half of patients who presented with cardiac events had a record of exposure only to marijuana.”

A limitation of the study is that cannabis use related to CV events was likely underreported, but “this paper does suggest a signal linking cannabis use to [CV] events and is deserving of our attention, underscoring the need for more research in this field,” Rezkalla and Kloner wrote.

They noted that randomized controlled trials to study the safety of marijuana might be unethical to conduct, but suggested “adoption of a similar system [to the French Addictovigilance Network] for mandatory reporting of medical complications of marijuana use in the United States. … It is the responsibility of the medical community to determine the safety of the drug before it is widely legalized for recreational use.”

For more information:

Jouanjus E. J Am Heart Assoc. 2014;doi:10.1161/JAHA.113.000638.

Rezkalla S. J Am Heart Assoc. 2014;doi:10.1161/JAHA.114.000904.

Disclosure: The study was funded by the French InterMinisterial Mission for the Fight Against Drugs and Addiction and the French drug agency Agence Nationale de Sécurité des Médicaments. The researchers, Rezkalla and Kloner report no relevant financial disclosures.

Increased reports of CV complications related to cannabis use suggest that it may be a possible risk factor for CVD in young adults.

Researchers analyzed data from the French Addictovigilance Network, a database of serious cases of abuse and dependence related to psychoactive substances.

From 2006 to 2010, there were 1,979 spontaneous reports of complications related to cannabis use reported. Of those, 35 (1.8%) were CV complications. The cases occurred mostly in men (85.7%) who were younger (mean age, 34 years).

Twenty-two cases involved cardiac complications, including 20 ACS; 10 involved peripheral complications, including lower limb or juvenile arteriopathies; and three involved cerebral complications, including acute cerebral angiopathy, transient cortical blindness and spasm of cerebral artery. Nine cases resulted in death.

Overall, the number of cases of CV complications increased from five (1.1% of cannabis-related reports) in 2006 to 11 (3.6% of cannabis-related reports) in 2010.

“Given that cannabis is perceived to be harmless by the general public and that legalization of its use is debated, data concerning its danger must be widely disseminated,” Emilie Jouanjus, PharmD, of Centre Hospitalier Universitaire de Toulouse in Toulouse, France, and colleagues wrote. “Practitioners should be aware that cannabis may be a potential triggering factor for [CV] complications in young people.”

Robert A. Kloner, MD, PhD, FACC

Robert A. Kloner

In a related editorial, Shereif Rezkalla, MD, FACP, FACC, from Marshfield Clinic, Marshfield, Wis., and Robert A. Kloner, MD, PhD, FACC, from Keck School of Medicine, University of Southern California, noted that “while the concomitant use of other products, such as tobacco and alcohol, may have contributed to some of these events, approximately half of patients who presented with cardiac events had a record of exposure only to marijuana.”

A limitation of the study is that cannabis use related to CV events was likely underreported, but “this paper does suggest a signal linking cannabis use to [CV] events and is deserving of our attention, underscoring the need for more research in this field,” Rezkalla and Kloner wrote.

They noted that randomized controlled trials to study the safety of marijuana might be unethical to conduct, but suggested “adoption of a similar system [to the French Addictovigilance Network] for mandatory reporting of medical complications of marijuana use in the United States. … It is the responsibility of the medical community to determine the safety of the drug before it is widely legalized for recreational use.”

For more information:

Jouanjus E. J Am Heart Assoc. 2014;doi:10.1161/JAHA.113.000638.

Rezkalla S. J Am Heart Assoc. 2014;doi:10.1161/JAHA.114.000904.

Disclosure: The study was funded by the French InterMinisterial Mission for the Fight Against Drugs and Addiction and the French drug agency Agence Nationale de Sécurité des Médicaments. The researchers, Rezkalla and Kloner report no relevant financial disclosures.