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Recreational cannabis use and myocardial infarction: association or causation? Volume 33, issue 5, September-October 2021

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Authors
1 Hôpital privé d’Antony, pôle cardiovasculaire interventionnel (PCVI 92), 25, rue de la Providence, 92160 Antony, France
2 Hôpital privé d’Antony, unité de soins intensifs cardiologie, Antony, France
* Tirés à part

Today, cannabis is the most frequently used psychoactive substance after alcohol and tobacco, particularly among young people, the main psychoactive constituent being 9-tetrahydrocannabinol (Δ-9-THC), responsible for the euphoric effects of cannabis. In parallel with increasing cannabis consumption and rising THC concentrations, a growing number of published case reports have described cannabis-induced adverse cardiovascular events such as myocardial infarction (MI). The literature suggests that cannabis use plays a role in inducing MI, particularly in young, otherwise healthy adults who present shortly after use. Increased autonomic stimulation, altered platelet aggregation, vasospasm, and toxic smoke constituents have all been proposed as explanations of this effect. However, it is likely that the true pathogenesis is multifactorial. As most studies are observational in nature, causality link, although not proven, is suggested by the existence of a temporal relation between occurrence of these complications and cannabis use. It would be desirable in cases of myocardial infarction of the young person, to systematically seek cannabis use.