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Desai R, Jain A, Patel BA, Sadolikar A, Alukal T. Young diabetics remain at higher risk of acute myocardial infarction with cannabis use disorder. Eur J Intern Med 2023; 108:125-127. [PMID: 36202716 DOI: 10.1016/j.ejim.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 02/07/2023]
Affiliation(s)
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA.
| | - Bhavin A Patel
- Department of Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, MI, USA
| | - Ashish Sadolikar
- Department of Internal Medicine, Indiana University Health Southern Indiana Physicians, Bloomington, IN, USA
| | - Thomas Alukal
- Department of Internal Medicine, VCU Health, South Hill, VA, USA
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Murtha L, Sathiadoss P, Salameh JP, Mcinnes MDF, Revah G. Chest CT Findings in Marijuana Smokers. Radiology 2022; 307:e212611. [PMID: 36378033 DOI: 10.1148/radiol.212611] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Global consumption of marijuana is increasing, but there is a paucity of evidence concerning associated lung imaging findings. Purpose To use chest CT to investigate the effects of marijuana smoking in the lung. Materials and Methods This retrospective case-control study evaluated results of chest CT examinations (from October 2005 to July 2020) in marijuana smokers, nonsmoker control patients, and tobacco-only smokers. We compared rates of emphysema, airway changes, gynecomastia, and coronary artery calcification. Age- and sex-matched subgroups were created for comparison with tobacco-only smokers older than 50 years. Results were analyzed using χ2 tests. Results A total of 56 marijuana smokers (34 male; mean age, 49 years ± 14 [SD]), 57 nonsmoker control patients (32 male; mean age, 49 years ± 14), and 33 tobacco-only smokers (18 male; mean age, 60 years ± 6) were evaluated. Higher rates of emphysema were seen among marijuana smokers (42 of 56 [75%]) than nonsmokers (three of 57 [5%]) (P < .001) but not tobacco-only smokers (22 of 33 [67%]) (P = .40). Rates of bronchial thickening, bronchiectasis, and mucoid impaction were higher among marijuana smokers compared with the other groups (P < .001 to P = .04). Gynecomastia was more common in marijuana smokers (13 of 34 [38%]) than in control patients (five of 32 [16%]) (P = .039) and tobacco-only smokers (two of 18 [11%]) (P = .040). In age-matched subgroup analysis of 30 marijuana smokers (23 male), 29 nonsmoker control patients (17 male), and 33 tobacco-only smokers (18 male), rates of bronchial thickening, bronchiectasis, and mucoid impaction were again higher in the marijuana smokers than in the tobacco-only smokers (P < .001 to P = .006). Emphysema rates were higher in age-matched marijuana smokers (28 of 30 [93%]) than in tobacco-only smokers (22 of 33 [67%]) (P = .009). There was no difference in rate of coronary artery calcification between age-matched marijuana smokers (21 of 30 [70%]) and tobacco-only smokers (28 of 33 [85%]) (P = .16). Conclusion Airway inflammation and emphysema were more common in marijuana smokers than in nonsmokers and tobacco-only smokers, although variable interobserver agreement and concomitant cigarette smoking among the marijuana-smoking cohort limits our ability to draw strong conclusions. © RSNA, 2022 See also the editorial by Galvin and Franks in this issue.
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Affiliation(s)
- Luke Murtha
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Paul Sathiadoss
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Jean-Paul Salameh
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Matthew D. F. Mcinnes
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Giselle Revah
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
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Durandel L, Sanchez S, Amiot-Chapoutot F, Dacunka M, Raoul F, Chapoutot L, Marchais A. [Acute coronary syndrome and cannabis use: a retrospective cohort study]. Ann Cardiol Angeiol (Paris) 2022; 71:252-258. [PMID: 36075767 DOI: 10.1016/j.ancard.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Acute coronary syndrome (ACS) is the usual clinical entry point for coronary heart disease. France is the European country with the highest prevalence of cannabis use and an increase in serious cardiovascular complications, including infarction, related to cannabis. The main objective was to compare the clinical and cardiological profile of patients with ACS according to exposure to cannabis use. POPULATION AND METHODS We conducted a retrospective, single-centre, exposure-non-exposure cohort study of all adult patients (> 18 years) admitted for ACS in the ICU between January 1, 2012 and December 31, 2021 at the Centre Hospitalier de Troyes, with mention of cannabis use in the medical record. A matching was performed so that each patient identified in the exposed group was associated with a comparable unexposed patient on age, sex, period of hospitalisation and cardiovascular event typology (type of ACS and topography for ST+). RESULTS 2745 patients admitted to the ICU and the coronary angiography room presented an ST+ or ST- ACS from 01/01/2012 to 31/12/2021 at the CHT. For 31 patients of them (1.1%), we noted cannabis consumption, which concern 7,9% of SCA ST+ aged under 50. DISCUSSION The link between cannabis use and ACS is established, but studies concerning the place of cannabis in the ACS pathway of an ICU are few in France. Our results show the interest of developing a specific pathway focused on the needs of patients and their specificities in post ACS management.
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Affiliation(s)
| | - Stéphane Sanchez
- MCU-PH Santé Publique, Pôle Territorial Santé publique et Performance, Unité de Recherche Clinique et de Recherche en Soins, Hôpitaux Champagne Sud, 101 avenue anatole France, 10000 Troyes, France.
| | | | - Marianne Dacunka
- Pôle vasculaire, Service de cardiologie, Centre hospitalier de Troyes, Troyes, France.
| | - Florian Raoul
- Pôle vasculaire, Service de cardiologie, Centre hospitalier de Troyes, Troyes, France.
| | - Laurent Chapoutot
- Pôle vasculaire, Service de cardiologie, Centre hospitalier de Troyes, Troyes, France.
| | - Aurélie Marchais
- Pôle vasculaire, Service de cardiologie, Centre hospitalier de Troyes, Troyes, France.
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Skipina TM, Patel N, Upadhya B, Soliman EZ. Cannabis Use is Associated with Prevalent Coronary Artery Disease. Am J Med Sci 2022; 364:304-308. [DOI: 10.1016/j.amjms.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/08/2021] [Accepted: 04/06/2022] [Indexed: 11/17/2022]
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Shariatnia S, Ziaratban M, Rajabi A, Salehi A, Abdi Zarrini K, Vakili M. Modeling the diagnosis of coronary artery disease by discriminant analysis and logistic regression: a cross-sectional study. BMC Med Inform Decis Mak 2022; 22:85. [PMID: 35351098 PMCID: PMC8966192 DOI: 10.1186/s12911-022-01823-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Coronary artery disease (CAD) is one of the most significant cardiovascular diseases that requires accurate angiography to diagnose. Angiography is an invasive approach involving risks like death, heart attack, and stroke. An appropriate alternative for diagnosis of the disease is to use statistical or data mining methods. The purpose of the study was to predict CAD by using discriminant analysis and compared with the logistic regression. MATERIALS AND METHODS This cross-sectional study included 758 cases admitted to Fatemeh Zahra Teaching Hospital (Sari, Iran) for examination and coronary angiography for evaluation of CAD in 2019. A logistics discriminant, Quadratic Discriminant Analysis (QDA) and Linear Discriminant Analysis (LDA) model and K-Nearest Neighbor (KNN) were fitted for prognosis of CAD with the help of clinical and laboratory information of patients. RESULTS Out of the 758 examined cases, 250 (32.98%) cases were non-CAD and 508 (67.22%) were diagnosed with CAD disease. The results indicated that the indices of accuracy, sensitivity, specificity and area under the ROC curve (AUC) in the linear discriminant analysis (LDA) were 78.6, 81.3, 71.3, and 81.9%, respectively. The results obtained by the quadratic discriminant analysis were respectively 64.6, 88.2, 47.9, and 81%. The values of the metrics in K-nearest neighbor method were 74, 77.5, 63.7, and 82%, respectively. Finally, the logistic regression reached 77, 87.6, 55.6, and 82%, respectively for the evaluation metrics. CONCLUSIONS The LDA method is superior to the Quadratic Discriminant Analysis (QDA), K-Nearest Neighbor (KNN) and Logistic Regression (LR) methods in differentiating CAD patients. Therefore, in addition to common non-invasive diagnostic methods, LDA technique is recommended as a predictive model with acceptable accuracy, sensitivity, and specificity for the diagnosis of CAD. However, given that the differences between the models are small, it is recommended to use each model to predict CAD disease.
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Affiliation(s)
- Sahar Shariatnia
- Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medica Science, Gorgan, Iran
| | - Majid Ziaratban
- Department of Electrical Engineering, Faculty of Engineering, Golestan University, Gorgan, Iran
| | - Abdolhalim Rajabi
- Health Management and Social Development Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Aref Salehi
- Ischemic Disorders Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Kobra Abdi Zarrini
- Intensive Care Unit of Fatemeh Zahra Hospital, Mazandaran University Medical Sciences, Sari, Iran
| | - Mohammadali Vakili
- Health Management and Social Development Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran.
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Stasiak A, Kędziora P. Myocardial ischaemia associated with tetrahydrocannabinol intake in a teenage boy: A case report. J Paediatr Child Health 2021; 57:1500-1504. [PMID: 33091958 DOI: 10.1111/jpc.15227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/24/2020] [Accepted: 09/27/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Aleksandra Stasiak
- Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland
| | - Piotr Kędziora
- Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Lodz, Poland
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Shah S, Patel S, Paulraj S, Chaudhuri D. Association of Marijuana Use and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Data Analysis of 133,706 US Adults. Am J Med 2021; 134:614-620.e1. [PMID: 33181103 DOI: 10.1016/j.amjmed.2020.10.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Marijuana is the most commonly used psychoactive drug, while its effects on cardiovascular health are not well known and remain a subject of interest. METHODS We used the pooled 2016-2018 data from the Behavioral Risk Factor Surveillance System to perform a cross-sectional analysis evaluating the association of marijuana and cardiovascular disease among US adults who never smoked cigarettes. RESULTS Among US adults ages 18-74 years, when compared with nonusers, frequent marijuana use was associated with 88% higher odds of myocardial infarction or coronary artery disease (adjusted odds ratio [aOR] 1.88; 95% confidence interval [CI], 1.15-3.08), and 81% higher odds of stroke (aOR 1.81; 95% CI, 1.14-2.89). Among the premature cardiovascular disease group, frequent marijuana users had 2.3 times higher odds of myocardial infarction or coronary artery disease (aOR 2.27; 95% CI, 1.20-4.30), and 1.9 times higher odds of stroke (aOR 1.92; 95% CI, 1.07-3.43). In terms of the modality of marijuana use, frequent marijuana smoking had 2.1 times higher odds of myocardial infarction or coronary artery disease (aOR 2.07; 95% CI, 1.21-3.56), and 1.8 times higher odds of stroke (aOR 1.84; 95% CI, 1.09-3.10). A similar association was observed in the premature cardiovascular disease group who smoked marijuana (aOR [for myocardial infarction or coronary artery disease] 2.64; 95% CI, 1.37-5.09; aOR [for stroke] 2.00; 95% CI, 1.05-3.79). No association was observed between marijuana use in any form other than smoking and cardiovascular disease, across all age groups. CONCLUSION Frequent marijuana smoking is associated with significantly higher odds of stroke and myocardial infarction or coronary artery disease, with a possible role in premature cardiovascular disease.
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Affiliation(s)
- Siddharth Shah
- Division of Cardiology, State University of New York Upstate Medical University, Syracuse.
| | - Siddharth Patel
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham
| | | | - Debanik Chaudhuri
- Division of Cardiology, State University of New York Upstate Medical University, Syracuse
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Lee MT, Mahtta D, Alam M, Ullah W, Nasir K, Hanif B, Virani SS. Contemporary outcomes studies to identify and mitigate the risk in patients with premature cardiovascular disease. Expert Rev Pharmacoecon Outcomes Res 2021; 21:559-570. [DOI: 10.1080/14737167.2021.1888718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Michelle T. Lee
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
| | - Dhruv Mahtta
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Mahboob Alam
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
| | - Waqas Ullah
- Department of Internal Medicine, Abington Jefferson Health, Abington, PA, USA
| | - Khurram Nasir
- Department of Cardiology, Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, USA
- Division of Cardiovascular Prevention and Wellness, Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Bashir Hanif
- Section of Cardiology, Tabba Heart Institute, Karachi, Pakistan
| | - Salim S. Virani
- Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, USA
- Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, USA
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