Marijuana, methamphetamine, cocaine and opiates are all associated with an increased risk of developing atrial fibrillation (AFib), according to new findings published in European Heart Journal.
“Though alcohol and tobacco smoking have each been associated with a heightened risk of AFib, relationships between other drug use and AFib are poorly understood,” wrote first author Anthony Lin, MD, a research fellow with the University of California, San Francisco (UCSF), and colleagues. “While previous work related to methamphetamines and arrhythmias has focused on fatal ventricular arrhythmogenic complications, little is still known about its association with more common cardiac arrhythmias like AFib and their associated comorbid complications. Similarly, prior literature regarding cocaine has centered on associations with fatal ventricular arrhythmias, with only small and experimental studies or case series linking its use with incident AFib.”
The researchers examined data from approximately 23.5 million patients who were treated in California from 2005 to 2015, including more than 132,000 cannabis users, more than 98,000 methamphetamine users, more than 48,000 cocaine users and more than 10,000 opiate users.
What stood out to Lin et al. the most, however, was the finding that marijuana use was linked to a 35% increase in the risk of AFib.
“Despite exhibiting a weaker association with incident AFib than the other substances, cannabis use still exhibited an association of similar or greater magnitude to risk factors like dyslipidemia, diabetes mellitus, and chronic kidney disease,” the authors wrote. “Furthermore, those with cannabis use exhibited similar relative risk of incident AFib as those with traditional tobacco use.”
Principal investigator Gregory Marcus, MD, MAS, a professor of medicine with the UCSF division of cardiology, noted in a prepared statement that the connection between marijuana use and AFib may be partially due to inhaled particulate matter, which increases inflammation.
“It’s also intriguing to consider that inhaled substances travel directly from the lungs to pulmonary veins, which empty into the left atrium, and that the pulmonary veins and the left atrium are especially important in generating AFib,” he said.
Marcus also emphasized in the same statement that lowering the number of people using these drugs can make a direct impact on AFib rates—and patient outcomes—throughout the United States.
“Efforts to reduce substance abuse have the potential to reduce long-term cardiovascular complications associated with AFib,” he said.