An exploratory prospective study of marijuana use and mortality following acute myocardial infarction
An exploratory prospective study of marijuana use and mortality following acute myocardial infarction
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DOI：
10.1016/j.ahj.2007.10.049
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发表时间：
2008-03-01
影响因子：
4.8
通讯作者：
Mittleman, Murray A.
中科院分区：
文献类型：
--
作者：
Mukamal, Kenneth J.;Maclure, Malcolm;Mittleman, Murray A.
背景大麻的使用与冠心病的关系，包括冠心病患者的预后，是不确定的。方法我们对1989-1994年间在美国45家医院住院的1913名成年心肌梗死患者进行了一项初始队列研究，中位随访时间为3.8年。结果52例患者报告前一年吸食大麻，3 17例患者在随访期间死亡。与不使用大麻相比，每周使用大麻少于一周的风险比为2.5(95，%CI，0.9-7.3)。每周使用或更多使用的相应危险比为4.2(95%CI，1.2-14.3)。年龄和性别调整后的危险比与任何使用任何药物相关的心血管死亡率为1.9(95%CI，0.6-6.3)，非心血管死亡率为4.9(95%CI，1.6-14.7)。在42名吸食大麻的患者和42名其他倾向性得分匹配的患者的比较中，吸食大麻的患者中有6人死亡，而不吸食大麻的患者中有1人死亡(LOG-RANK P=0.06)。结论这些初步结果表明，大麻对急性心肌梗死患者可能存在危险。尽管在其他人群中，大麻的使用与死亡率没有关联，但它可能会对患有冠心病的易感人群构成特别的风险。
Background The relationship of marijuana use with coronary heart disease, including prognosis among patients with coronary heart disease, is uncertain.Methods We conducted an inception cohort study of 1913 adults hospitalized with myocardial infarction at 45 US hospitals between 1989 and 1994, with a median follow-up of 3.8 years. We ascertained total mortality according to self-reported marijuana use in the preceding year.Results A total of 52 patients reported marijuana use during the prior year, and 3 17 patients died during follow-up. Compared with nonuse, marijuana use less than weekly was associated with a hazard ratio of 2.5 (95, % CI, 0.9-7.3). The corresponding hazard ratio for weekly use or more was 4.2 (95% CI, 1.2-14.3). The age- and sex-adjusted hazard ratios associated with any use were 1.9 (95% CI, 0.6-6.3) for cardiovascular mortality and 4.9 (95% CI, 1.6-14.7) for noncardiovascular mortality. In a comparison of 42 marijuana users and 42 other patients matched on propensity scores, there were 6 deaths among marijuana users and one among non-users (log-rank P = .06).Conclusions These preliminary results suggest possible hazards of marijuana for patients who survive acute myocardial infarction. Although marijuana use has not been associated with mortality in other populations, it may pose particular risk for susceptible individuals with coronary heart disease.