Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies
Background: Cannabis is the most used illicit drug in the world. Global trends of decriminalization and legalization of cannabis lead to various forms of cannabis use and bring great concerns over adverse events, particularly in the cardiovascular (CV) system. To date, the association between cannab...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Toxicology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214750023000483 |
| _version_ | 1827920327440596992 |
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| author | Nonthikorn Theerasuwipakorn Somchai Prechawat Ronpichai Chokesuwattanaskul Noppachai Siranart Apichai Marsukjai Suthimon Thumtecho Voravut Rungpradubvong |
| author_facet | Nonthikorn Theerasuwipakorn Somchai Prechawat Ronpichai Chokesuwattanaskul Noppachai Siranart Apichai Marsukjai Suthimon Thumtecho Voravut Rungpradubvong |
| author_sort | Nonthikorn Theerasuwipakorn |
| collection | DOAJ |
| description | Background: Cannabis is the most used illicit drug in the world. Global trends of decriminalization and legalization of cannabis lead to various forms of cannabis use and bring great concerns over adverse events, particularly in the cardiovascular (CV) system. To date, the association between cannabis and adverse CV events is still controversial. Purpose: We aim to conduct a systematic review and meta-analysis to assess the adverse CV events from cannabis use. Patients and methods: A systematic search for publications describing the adverse CV events of cannabis use, including acute myocardial infarction (MI) and stroke, was performed via PubMed, Scopus, and Cochrane Library databases. Data on effect estimates in individual studies were extracted and combined via random-effects meta-analysis using the DerSimonian and Laird method, a generic inverse-variance strategy. Results: Twenty studies with a total of 183,410,651 patients were included. The proportion of males was 23.7%. The median age and follow-up time were 42.4 years old (IQR: 37.4, 50.0) and 6.2 years (IQR: 1.7, 27.7), respectively. The prevalence of cannabis use was 1.9%. Cannabis use was not significantly associated with acute MI (pooled odds ratio (OR): 1.29; 95%CI: 0.80, 2.08), stroke (pooled OR 1.35; 95%CI: 0.74, 2.47), and adverse CV events (pooled OR: 1.47; 95%CI: 0.98, 2.20). Conclusion: The risk of adverse CV events including acute MI and stroke does not exhibit a significant increase with cannabis exposure. However, caution should be exercised when interpreting the findings due to the heterogeneity of the studies. |
| first_indexed | 2024-03-13T04:10:13Z |
| format | Article |
| id | doaj.art-2fe1ef0a797c4922974804a35a25fc4e |
| institution | Directory Open Access Journal |
| issn | 2214-7500 |
| language | English |
| last_indexed | 2024-03-13T04:10:13Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Toxicology Reports |
| spelling | doaj.art-2fe1ef0a797c4922974804a35a25fc4e2023-06-21T06:55:11ZengElsevierToxicology Reports2214-75002023-01-0110537543Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studiesNonthikorn Theerasuwipakorn0Somchai Prechawat1Ronpichai Chokesuwattanaskul2Noppachai Siranart3Apichai Marsukjai4Suthimon Thumtecho5Voravut Rungpradubvong6Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center of Excellence in Arrhythmia Research Chulalongkorn University, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandFaculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Toxicology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center of Excellence in Arrhythmia Research Chulalongkorn University, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Correspondence to: King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand.Background: Cannabis is the most used illicit drug in the world. Global trends of decriminalization and legalization of cannabis lead to various forms of cannabis use and bring great concerns over adverse events, particularly in the cardiovascular (CV) system. To date, the association between cannabis and adverse CV events is still controversial. Purpose: We aim to conduct a systematic review and meta-analysis to assess the adverse CV events from cannabis use. Patients and methods: A systematic search for publications describing the adverse CV events of cannabis use, including acute myocardial infarction (MI) and stroke, was performed via PubMed, Scopus, and Cochrane Library databases. Data on effect estimates in individual studies were extracted and combined via random-effects meta-analysis using the DerSimonian and Laird method, a generic inverse-variance strategy. Results: Twenty studies with a total of 183,410,651 patients were included. The proportion of males was 23.7%. The median age and follow-up time were 42.4 years old (IQR: 37.4, 50.0) and 6.2 years (IQR: 1.7, 27.7), respectively. The prevalence of cannabis use was 1.9%. Cannabis use was not significantly associated with acute MI (pooled odds ratio (OR): 1.29; 95%CI: 0.80, 2.08), stroke (pooled OR 1.35; 95%CI: 0.74, 2.47), and adverse CV events (pooled OR: 1.47; 95%CI: 0.98, 2.20). Conclusion: The risk of adverse CV events including acute MI and stroke does not exhibit a significant increase with cannabis exposure. However, caution should be exercised when interpreting the findings due to the heterogeneity of the studies.http://www.sciencedirect.com/science/article/pii/S2214750023000483CannabisMarijuanaMyocardial infarctionStrokeCardiovascular eventSystematic review |
| spellingShingle | Nonthikorn Theerasuwipakorn Somchai Prechawat Ronpichai Chokesuwattanaskul Noppachai Siranart Apichai Marsukjai Suthimon Thumtecho Voravut Rungpradubvong Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies Toxicology Reports Cannabis Marijuana Myocardial infarction Stroke Cardiovascular event Systematic review |
| title | Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies |
| title_full | Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies |
| title_fullStr | Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies |
| title_full_unstemmed | Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies |
| title_short | Cannabis and adverse cardiovascular events: A systematic review and meta-analysis of observational studies |
| title_sort | cannabis and adverse cardiovascular events a systematic review and meta analysis of observational studies |
| topic | Cannabis Marijuana Myocardial infarction Stroke Cardiovascular event Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2214750023000483 |
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