Cannabis use and short-term outcomes of patients admitted to a moroccan cardiology department

Introduction

Cannabis is the most widely consumed recreational drug globally, and its use is notably prevalent across all age demographics in Morocco. Recent epidemiological data highlight significant consumption rates spanning generations, with an estimated 11.1% prevalence among the general adult population [1, 2]. Alongside this , mounting evidence indicates that cannabis is a potent trigger for acute cardiovascular events [3,4]. We aimed to evaluate the clinical profile, angiographic characteristics, and short-term outcomes of cannabis users admitted to the Cardiology Department.

Methods

This single-center, retrospective observational study was conducted over a 3-year period. Baseline characteristics, clinical presentations, angiographic findings, and short-term outcomes were evaluated in a cohort of 3,180 cardiology inpatients. We compared patients with identified cannabis use against the general cardiology population. Outcomes assessed included in-hospital mortality and 30-day readmission for recurrent ischemia or heart failure.

Results

Of the 3,180 admitted patients, 354 (11.1%) were identified as cannabis users. Compared to the general inpatient cohort, cannabis users were younger (mean age 62 vs. 64 years) and predominantly male (77.1% vs. 55.1%). The cannabis cohort exhibited a paradoxically lower prevalence of traditional cardiovascular risk factors, including hypertension (18.6% vs. 29.2%) and obesity (6.8% vs. 42.0%).

The primary indication for admission among cannabis users was ischemic heart disease (66.9%), followed by arrhythmias (7.6%) and thromboembolic events (5.9%), with the vast majority necessitating CICU admission. Coronary angiography (performed in 52.3% of cannabis users) revealed a notably high burden of thrombotic lesions, requiring stent implantation in 41.7% of the patients. Furthermore, two in-hospital deaths in this group were directly attributed to refractory coronary vasospasm. Echocardiographic evaluation demonstrated severe left ventricular systolic dysfunction in the cannabis cohort (mean LVEF 30-35%). Subsequent cardiac MRI in a subset of these patients (n=27) confirmed a complete absence of myocardial viability, leading to exclusive medical management. Regarding short-term outcomes, in-hospital mortality was distinctly higher in the cannabis group (10.2% vs. 8.4%), as was the 30-day readmission rate (14.5% vs. 9.8%).

Conclusions

Cannabis use in patients admitted to the cardiology department is associated with severe ischemic presentations characterized by high thrombotic burden, coronary vasospasm, and profound left ventricular dysfunction. Despite being younger and having fewer traditional risk factors, cannabis users face worse short-term outcomes, including higher in-hospital mortality. These findings emphasize the critical need for systematic drug screening on admission and the implementation of aggressive, targeted secondary prevention strategies.