Marijuana Use and the Risk of Early Ischemic Stroke: The Stroke Prevention in Young Adults Study.
Marijuana Use and the Risk of Early Ischemic Stroke: The Stroke Prevention in Young Adults Study.
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DOI：
10.1161/strokeaha.120.032811
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发表时间：
2021-10
期刊：
影响因子：
8.3
通讯作者：
Cole JW
中科院分区：
文献类型：
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作者：
Dutta T;Ryan KA;Thompson O;Lopez H;Fecteau N;Sparks MJ;Chaturvedi S;Cronin C;Mehndiratta P;Nunez Gonzalez JR;Phipps M;Wozniak M;McArdle PF;Kittner SJ;Cole JW
很少有研究检查大麻使用与缺血性中风之间的剂量反应和时间关系，同时控制重要的混杂因素，包括吸烟量。我们研究的目的是解决这些知识差距。一项以人群为基础的病例对照研究，包括 1,090 例病例和 1,152 名对照组，旨在调查吸食大麻与早发性缺血性中风的关系。巴尔的摩-华盛顿地区 59 家医院发现了首例缺血性中风病例，年龄在 15 岁至 49 岁之间。通过随机数字拨号从同一地理区域获得的对照按年龄、性别、居住地区以及种族（初始研究阶段除外）与病例进行频率匹配。排除使用可卡因和其他血管活性物质的受试者后，最终研究样本由 751 例病例和 813 例对照组成。所有参与者都接受了标准化访谈，以了解中风危险因素和大麻使用情况。采用无条件逻辑回归分析来评估大麻使用与缺血性中风风险之间的关系，并调整年龄、性别、种族、研究阶段、当前吸烟量、当前饮酒量、高血压和糖尿病。在调整其他风险因素（包括当前吸烟量）后，吸食大麻与缺血性中风无关，无论吸食时间与中风的关系如何，包括曾经吸食、30 天内吸食和 24 小时内吸食。每周至少吸食一次大麻的人中风风险增加的趋势并不显着（OR=1.9，95%CI=0.8-4.9）。这些分析并未证明吸食大麻与早发性缺血性中风风险增加之间存在关联，尽管统计能力对于评估大量吸食者之间的关联性有限。
Few studies have examined the dose-response and temporal relationships between marijuana use and ischemic stroke while controlling for important confounders, including amount of tobacco smoking. The purpose of our study was to address these knowledge gaps. A population-based case-control study with 1,090 cases and 1,152 controls was used to investigate the relationship of marijuana use and early-onset ischemic stroke. Cases were first-ever ischemic stroke between the ages of 15 and 49 identified from 59 hospitals in the Baltimore-Washington region. Controls obtained by random digit dialing from the same geographic region were frequency-matched to cases by age, sex, region of residence and, except for the initial study phase, race. After excluding subjects with cocaine and other vasoactive substance use, the final study sample consisted of 751 cases and 813 controls. All participants underwent standardized interviews to characterize stroke risk factors and marijuana use. Unconditional logistic regression analysis was used to assess the relationships between marijuana use and risk of ischemic stroke, adjusting for age, sex, race, study phase, the amount of current tobacco smoking, current alcohol use, hypertension, and diabetes mellitus. After adjusting for other risk factors, including the amount of current tobacco smoking, marijuana use was not associated with ischemic stroke, regardless of the timing of use in relationship to the stroke, including ever use, use within 30 days, and use within 24 hours. There was a non-significant trend towards increased stroke risk among those who smoked marijuana at least once a week (OR=1.9, 95%CI=0.8–4.9). These analyses do not demonstrate an association between marijuana use and an increased risk of early-onset ischemic stroke, although statistical power was limited for assessing the association among very heavy users.