Marijuana use and long-term mortality among survivors of acute myocardial infarction.
Marijuana use and long-term mortality among survivors of acute myocardial infarction.
复制标题
DOI：
10.1016/j.ahj.2012.11.007
复制
发表时间：
2013-02
影响因子：
4.8
通讯作者：
Mittleman, Murray A.
中科院分区：
文献类型：
--
作者：
Frost, Lauren;Mostofsky, Elizabeth;Rosenbloom, Joshua I.;Mukamal, Kenneth J.;Mittleman, Murray A.
据报道，吸食大麻会增加使用后立即发生心肌梗死（MI）的风险，但对已确诊冠心病患者使用大麻的长期影响知之甚少。心肌梗死发病决定因素研究（MIOS）是一项多中心初始队列研究，纳入1989-1996年的心肌梗死患者，并使用国家死亡指数追踪死亡率。在对1935名心肌梗死幸存者的初步分析中，我们发现大麻使用者的死亡率增加，随访时间中位数为3.8年。本论文纳入3886例MIOS患者，随访时间长达18年。我们使用Cox比例风险模型来计算大麻使用与死亡率之间关联的风险比和95%置信区间，并使用倾向评分匹配分析来进一步控制混淆。在长达18年的随访中，519名患者死亡，其中109名患者中有22名报告在心肌梗死前一年使用过大麻。大麻使用与死亡率之间没有统计学上的显著关联。与不使用大麻的人相比，报告使用大麻的人的死亡率高出29%（95%置信区间0.81至2.05,p=0.28）。急性心肌梗死患者的习惯性大麻使用与随后18年的死亡率明显增加相关，但没有达到名义统计学意义。需要更大规模的研究，反复测量大麻的使用情况，以明确确定在已确诊的冠心病患者中，吸食大麻是否有不良的心血管后果。
Smoking marijuana has been reported to increase risk of myocardial infarction (MI) immediately after use, but less is known about the long-term impact of marijuana use among patients with established coronary disease. The Determinants of MI Onset Study (MIOS) is a multicenter inception cohort study of MI patients enrolled in 1989–1996 and followed for mortality using the National Death Index. In an initial analysis of 1935 MI survivors followed for a median of 3.8 years, we found an increased mortality rate among marijuana users. The current paper includes 3886 MIOS patients followed for up to 18 years. We used Cox proportional hazards models to calculate the hazard ratio and 95% confidence interval for the association between marijuana use and mortality and a propensity score matched analysis to further control confounding. Over up to 18 years of follow-up, 519 patients died, including 22 of the 109 reporting marijuana use in the year prior to their MI. There was no statistically significant association between marijuana use and mortality. Compared to non-users, the mortality rate was 29% higher (95% confidence interval 0.81 to 2.05, p=0.28) among those reporting any marijuana use. Habitual marijuana use among patients presenting with acute MI was associated with an apparent increased mortality rate over the following 18 years that did not reach nominal statistical significance. Larger studies with repeated measures of marijuana use are needed to definitively establish whether there are adverse cardiovascular consequences of smoking marijuana among patients with established coronary heart disease.
登录
查看更多内容
影响因子：
4.8
作者：
Mukamal, Kenneth J.;Maclure, Malcolm;Mittleman, Murray A.
通讯作者：
Mittleman, Murray A.
影响因子：
158.5
作者：
WU, TC;TASHKIN, DP;ROSE, JE
通讯作者：
ROSE, JE
影响因子：
2.9
作者：
Jones, RT
通讯作者：
Jones, RT
影响因子：
39.3
作者：
Quercioli, Alessandra;Pataky, Zoltan;Schindler, Thomas H.
通讯作者：
Schindler, Thomas H.
影响因子：
2.9
作者：
Sidney, S
通讯作者：
Sidney, S