Historique
Article de Périodique
Medical cannabis authorization and the risk of cardiovascular events: a longitudinal cohort study (2021)
Auteur(s) :
ZONGO, A. ;
LEE, C. ;
DYCK, J. R. B. ;
EL-MOURAD, J. ;
HYSHKA, E. ;
HANLON, J. G. ;
EURICH, D. T.
Année
2021
Page(s) :
art. 426
Langue(s) :
Anglais
Refs biblio. :
24
Domaine :
Drogues illicites / Illicit drugs
Discipline :
PAT (Pathologie organique / Organic pathology)
Thésaurus géographique
CANADA
Thésaurus mots-clés
ETUDE LONGITUDINALE
;
CANNABIS
;
USAGE THERAPEUTIQUE
;
LEGALISATION
;
FACTEUR DE RISQUE
;
APPAREIL CARDIOVASCULAIRE
;
HOSPITALISATION
;
ARRET CARDIAQUE
;
URGENCE
Résumé :
Background: Cannabis is increasingly used for therapeutic purpose. However, its safety profile is not well known. This study assessed the risk of cardiovascular-related emergency department (ED) visit and hospitalization in adult patients authorized to use medical cannabis in Ontario, Canada from 2014 to 2017.
Methods: This is a longitudinal cohort study of patients who received medical cannabis authorization and followed-up in cannabis clinics, matched to population-based controls. The primary outcome was an ED visit or hospitalization for acute coronary syndrome (ACS) or stroke; and secondary outcome was for any cardiovascular event. Conditional Cox proportional hazards regression was used to assess the association between cannabis authorization and risk.
Results: 18,653 cannabis patients were matched to 51,243 controls. During a median follow-up of 242 days, the incidence rates for ACS or stroke were 7.19/1000 person-years and 5.67/1000 person-years in the cannabis and controls group, respectively-adjusted hazard ratio (aHR) of 1.44 (95% CI 1.08-1.93). When stratified by sex, the association was only statistically significant among males: aHR 1.77 (1.23-2.56). For the secondary outcome (any CV events), the aHR was 1.47 (1.26-1.72). The aHR among males and females were 1.52 (1.24-1.86) and 1.41 (1.11-1.79), respectively. Tested interaction between cannabis authorization and sex was not significant (p > 0.05).
Conclusions: Medical cannabis authorization was associated with an increased risk of ED visits or hospitalization for CV events including stroke and ACS.
Highlights:
Among the safety concerns of medical cannabis use, there is limited data on the possible increased risk of cardiovascular events associated with the use of cannabis.
This study is one of the few large epidemiological cohort studies that assesses the risk of cardiovascular CV events associated with the use of medical cannabis among patients in Ontario, Canada - 2014-2017.
Overall, our results suggest that medical cannabis authorization was associated with a short-term increased risk of emergency department visit and hospitalization for cardiovascular events.
Methods: This is a longitudinal cohort study of patients who received medical cannabis authorization and followed-up in cannabis clinics, matched to population-based controls. The primary outcome was an ED visit or hospitalization for acute coronary syndrome (ACS) or stroke; and secondary outcome was for any cardiovascular event. Conditional Cox proportional hazards regression was used to assess the association between cannabis authorization and risk.
Results: 18,653 cannabis patients were matched to 51,243 controls. During a median follow-up of 242 days, the incidence rates for ACS or stroke were 7.19/1000 person-years and 5.67/1000 person-years in the cannabis and controls group, respectively-adjusted hazard ratio (aHR) of 1.44 (95% CI 1.08-1.93). When stratified by sex, the association was only statistically significant among males: aHR 1.77 (1.23-2.56). For the secondary outcome (any CV events), the aHR was 1.47 (1.26-1.72). The aHR among males and females were 1.52 (1.24-1.86) and 1.41 (1.11-1.79), respectively. Tested interaction between cannabis authorization and sex was not significant (p > 0.05).
Conclusions: Medical cannabis authorization was associated with an increased risk of ED visits or hospitalization for CV events including stroke and ACS.
Highlights:
Among the safety concerns of medical cannabis use, there is limited data on the possible increased risk of cardiovascular events associated with the use of cannabis.
This study is one of the few large epidemiological cohort studies that assesses the risk of cardiovascular CV events associated with the use of medical cannabis among patients in Ontario, Canada - 2014-2017.
Overall, our results suggest that medical cannabis authorization was associated with a short-term increased risk of emergency department visit and hospitalization for cardiovascular events.
Affiliation :
Faculty of Pharmacy, Université Laval, Quebec City, QC, Canada