David M Chye, Thalys Sampaio Rodrigues, Levindo Jg Quarto, Naomie Young, Garry W Hamilton, Louise M Burrell, Andrew W Teh, Han S Lim, Anoop N Koshy
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Odds ratios (OR) and 95% confidence intervals (CIs) were pooled using a random-effects model. The study was prospectively registered (PROSPERO CRD42023428219).</p><p><strong>Results: </strong>Fourteen observational studies were included with 81,230,930 participants from North America, Europe and Oceania. Mean age was 47.2 years. 63.3% of participants were female. Five studies were prospective. AA was observed in 1.9% of participants (n = 1,578,033), i.e. 12.5% (n = 90,195) of cannabis users and 2.7% (n = 1,487,838) of controls. Cannabis was associated with a 71% increased risk of atrial arrhythmias (95% CI 1.1-2.6, p=0.01). Factors associated with further increased AA risk included concomitant drug use (OR: 1.91, 95% CI 1.1-3.5, p=0.03) and consumption in cannabis-legal countries (OR 1.93, 95% CI 1.1-3.5, p = 0.03).</p><p><strong>Conclusions: </strong>Cannabis use was associated with a 71% increased risk of atrial arrhythmias. 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引用次数: 0
摘要
背景：四氢大麻酚（THC）是大麻的主要成分，可引起交感神经刺激和内皮功能障碍。美国心脏协会最近的一份共识文件概述了与大麻使用相关的心血管风险。然而，关于心房心律失常（AA）的资料有限。目的：探讨大麻使用与心房心律失常风险之间的关系。方法：检索MEDLINE、Embase和Cochrane中央对照试验登记处截至2024年4月发表的关于大麻使用和心房颤动/扑动/心动过速、室上性心动过速的研究文章。使用随机效应模型合并优势比（OR）和95%置信区间（ci）。该研究已前瞻性注册（PROSPERO CRD42023428219）。结果：14项观察性研究纳入了来自北美、欧洲和大洋洲的81230930名参与者。平均年龄47.2岁。63.3%的参与者为女性。5项研究为前瞻性研究。在1.9%的参与者（n = 1,578,033）中观察到AA，即12.5% （n = 90,195）的大麻使用者和2.7% （n = 1,487,838）的对照组。大麻与房性心律失常风险增加71%相关（95% CI 1.1-2.6, p=0.01）。进一步增加AA风险的相关因素包括伴随药物使用（OR: 1.91, 95% CI 1.1-3.5, p=0.03）和大麻合法国家的消费（OR: 1.93, 95% CI 1.1-3.5, p=0.03）。结论：大麻使用与房性心律失常风险增加71%相关。对非西方国家和青少年人口的研究严重缺乏，这是未来研究的关键领域，以便更好地为公共卫生和合法化政策提供信息。
Cannabis Use and Atrial Arrhythmias: A Systematic Review and Meta-analysis of Large Populational Studies.
Background: Tetrahydrocannabinol (THC), a major component of cannabis, causes sympathetic stimulation and endothelial dysfunction. A recent American Heart Association consensus document has outlined cardiovascular risks associated with cannabis use. However, there is limited data surrounding atrial arrhythmias (AA).
Objectives: To investigate the association between cannabis use and the risk of atrial arrhythmias.
Methods: MEDLINE, Embase and Cochrane Central Register of Controlled Trials were searched for articles published up to April 2024 for studies on cannabis use and AAs (atrial fibrillation/flutter/tachycardia, supraventricular tachycardia). Odds ratios (OR) and 95% confidence intervals (CIs) were pooled using a random-effects model. The study was prospectively registered (PROSPERO CRD42023428219).
Results: Fourteen observational studies were included with 81,230,930 participants from North America, Europe and Oceania. Mean age was 47.2 years. 63.3% of participants were female. Five studies were prospective. AA was observed in 1.9% of participants (n = 1,578,033), i.e. 12.5% (n = 90,195) of cannabis users and 2.7% (n = 1,487,838) of controls. Cannabis was associated with a 71% increased risk of atrial arrhythmias (95% CI 1.1-2.6, p=0.01). Factors associated with further increased AA risk included concomitant drug use (OR: 1.91, 95% CI 1.1-3.5, p=0.03) and consumption in cannabis-legal countries (OR 1.93, 95% CI 1.1-3.5, p = 0.03).
Conclusions: Cannabis use was associated with a 71% increased risk of atrial arrhythmias. Significant paucity of research in non-Western and teenage populations comprise key areas for future research to better inform public health and legalization policies.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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