Atrial Fibrillation High Risk Group Revealed in Study Involving a Million Patients

A recent study by UC San Francisco researchers suggests that some regularly used and abused drugs, such as marijuana, methamphetamine, cocaine, and opiates, represent previously unrecognized risks for the development of atrial fibrillation (AF).

Research Analysis on the Development of Atrial Fibrilliation

According to Medical Xpress, for the years 2005 through 2015, the researchers examined information from diagnostic codes from each hospital admission, ER visit, and medical procedure in California. They identified around a million patients who later acquired AF during these years despite not having AF at the time. Patients in the databases under investigation utilized 132,834 cannabis, 98,271 methamphetamine, 48,700 cocaine, and 10,032 opiates.

The UCSF researchers discovered that marijuana users had a 35 percent higher risk of later having AF in the longitudinal study, which was published in the European Heart Journal.
Marcus's research group discovered that methamphetamine use most significantly raised the probability of AF by 86 percent in individuals whose medical records indicated usage versus those whose records did not. Use of opiates was linked to a 74 percent increased risk of AF and cocaine use to a 61 percent rise in risk.

Marijuana Users May Develop Atrial Fibrillation

Cannabis usage nonetheless showed a connection of equal or greater size with risk variables such as dyslipidemia, diabetes mellitus, and chronic renal disease, despite showing a lesser association with incidence of AF than the other substances. Additionally, those who used cannabis had a comparable relative risk of an occurrence of AF as those who used regular tobacco.
This is the first study to look at marijuana usage as a predictor of future atrial fibrillation risk, according to the study's principal investigator, Gregory Marcus, MD, MAS, a UCSF professor of medicine with the Division of Cardiology.

Atrial Fibrillation

AF is caused by electrical abnormalities in the atria, the heart's upper chambers. When atrial pumping is severely impaired, clots may form in the atria, separate, enter the bloodstream, and result in fatal strokes. Each year, more than 150,000 people die in the US as a result of AF-related strokes.

There is no established mechanism by which marijuana use results in heart arrhythmias, unlike cocaine or methamphetamine use, both stimulants previously known to occasionally result in sudden cardiac death due to severe disruptions in the regular electrical signaling and pumping within the heart's other chambers, the ventricles.

According to Marcus, inhaled particles are probably a contributing impact even though the study was not intended to investigate specific marijuana ingredients that may be to blame for increased AF risk.
Particulate matter, like tobacco smoke, a known risk factor, may enhance the incidence of an AF episode in people who have already been diagnosed with the illness, according to limited data from earlier research. Inflammation is a known AF cause, and breathing in particulate particles makes it worse.

It's also interesting to think about the fact that things that are inhaled go straight from the lungs to the pulmonary veins. According to Marcus, the pulmonary veins and left atrium play a particularly significant role in the development of AF because they empty into the left atrium.

Marijuana Usage in the US

The Office of Statewide Health Planning and Development, the California State Ambulatory Surgery databases, the Emergency Department databases, and the State Inpatient databases provided the researchers with medical records.

According to research cited by the Centers for Disease Control and Prevention, marijuana usage is rising in the United States, where 48 million individuals use it annually, and roughly 9% of first-time cannabis users develop drug dependence within ten years. In 2021, there were 80,816 opiate overdose deaths in the United States, compared to 32,856 methamphetamine overdose deaths.

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