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Young diabetics remain at higher risk of acute myocardial infarction with cannabis use disorder

Published:October 03, 2022DOI:https://doi.org/10.1016/j.ejim.2022.09.026
      Diabetes mellitus (DM) is a known risk factor for cardiovascular complications. Diabetic patients have higher rates of morbidity, mortality, and reinfarction following myocardial infarction than non-diabetics. Cannabis is one of the most used substances for recreational purposes with approximately 200 million users worldwide. In 2020 the National Institute of Drug Abuse reported that 50 million Americans ages 12 and older had used cannabis within the past year. Chronic or regular use of cannabis may adversely affect the cardiovascular, neurological, and mental health of the population [
      • Desai R.
      • Patel U.
      • Sharma S.
      • et al.
      Recreational Marijuana use and acute myocardial infarction: insights from nationwide inpatient sample in the United States.
      ,
      • Desai R.
      • Singh S.
      • Patel K.
      • et al.
      Stroke in young cannabis users (18–49 years): national trends in hospitalizations and outcomes.
      ]. There is an association between recreational cannabis use and both acute and chronic adverse effects of type 1 and type 2 diabetes mellitus [T1DM and T2DM] including a significant increase in HbA1C with a higher risk for diabetic ketoacidosis (DKA) in T1DM and higher rates of peripheral arterial occlusions, and renal disease in people with T2DM [
      • Porr C.J.
      • Rios P.
      • Bajaj H.S.
      • et al.
      The effects of recreational cannabis use on glycemic outcomes and self-management behaviours in people with type 1 and type 2 diabetes: a rapid review.
      ]. Tam et al. in their review detailed the differential regulation of cannabinoid receptors and subsequent amelioration of kidney function, especially with the background of DM and obesity [
      • Tam J.
      • Hinden L.
      • Drori A.
      • Udi S.
      • Azar S.
      • Baraghithy S.
      The therapeutic potential of targeting the peripheral endocannabinoid/CB(1) receptor system.
      ]. Despite this, there is no contemporary data to establish the burden of acute cardiovascular events in young diabetics with cannabis use. Therefore, we evaluated the risk and outcomes of acute myocardial infarction (AMI) in young diabetics with cannabis use disorder in light of significantly increasing trends of cannabis use in young.

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