Abstract
BackgroundCannabis 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.MethodsThis 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.Results18,653 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).ConclusionsMedical cannabis authorization was associated with an increased risk of ED visits or hospitalization for CV events including stroke and ACS.
Highlights
Cannabis is increasingly used for therapeutic purpose
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
Summary
Cannabis is increasingly used for therapeutic purpose. 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. Because the safety profile of cannabis remains unclear [6], the increasing use of cannabis could have unintended negative consequences for the users, the healthcare systems and public health in general. The possible increased risk of cardiovascular (CV) events associated with the use of cannabis is of concern [7]. An association between cannabis use and the risk of CV event was not found [13, 14]
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