Cannabis Users Had 3x Higher Odds of Serious Complications After Heart Attacks | Research

The takeaway

Among 772 patients hospitalized for acute coronary syndrome, the 11% who tested positive for recent cannabis use had over three times the odds of serious in-hospital complications.

Cannabis users concerned about cardiovascular risks, healthcare providers in emergency cardiac care.

Cannabis-positive patients had 3.68x higher odds of major adverse cardiac events

What the researchers found

Systematic urine screening across 39 French hospitals found 11.1% of acute coronary syndrome patients tested positive for cannabis. After adjusting for other risk factors and severity predictors, cannabis detection was associated with 3.28 to 3.68 times higher odds of major adverse events including death, cardiac arrest, and cardiogenic shock.

Why it matters

Most cardiovascular cannabis research relies on self-reported use. This study used objective urine testing in a real-world hospital setting, providing harder evidence for a link between cannabis use and worse outcomes after heart events.

The numbers in context

772 patients hospitalized for acute coronary syndrome. 86 (11.1%) tested positive for cannabis. Cannabis-positive patients were younger (53 vs 65 years) and more often male (88% vs 72%). 33 major adverse events occurred (4.3%). Adjusted odds ratios: 3.28 (adjusted for comorbidities) and 3.68 (adjusted for severity predictors).

How the study worked

Prospective multicenter study across 39 intensive cardiac care units in France over two weeks in April 2021. All consecutive patients admitted for acute coronary syndrome underwent systematic urine drug screening. Major adverse events were tracked during hospitalization.

What this study cannot tell us

Urine testing detects recent use but does not confirm acute intoxication at the time of the cardiac event. Two-week enrollment period may limit generalizability. Observational design cannot establish causation.

How to read the evidence

Moderate: prospective multicenter design with objective drug testing and adjustment for confounders, but observational and cannot prove causation.

When this study was published

2025 study using data from April 2021.

The bigger picture

This study adds to growing evidence that cannabis use may complicate cardiovascular events. As cannabis use becomes more common, understanding its interaction with acute cardiac conditions becomes increasingly relevant for emergency medicine.

Questions still open

Is the association driven by acute intoxication effects on the cardiovascular system, or by chronic use-related changes? Does the method of cannabis consumption (smoking vs other) affect cardiac risk?

Common questions

How was cannabis use detected?

Through systematic urine drug screening performed on admission in all patients, not self-report.

Were cannabis users different from non-users in other ways?

Yes, they were significantly younger (average 53 vs 65 years) and more often male (88% vs 72%), but the association with worse outcomes held after statistical adjustment for these and other differences.

Read the original research

In-hospital outcomes following an acute coronary syndrome in patients with recent cannabis use.

Archives of cardiovascular diseases, 118(3), 152-160

View on PubMed ↗Publisher’s paper ↗

Citation

Léquipar, Antoine; Dillinger, Jean-Guillaume; Bonnefoy-Cudraz, Eric; Albert, Emeric; Attou, Sabir; Auvray, Simon; Azzakani, Sonia; Boccara, Albert; Bouchot, Océane; Brette, Jean-Baptiste; Canu, Marjorie; Chaussade, Anne Solene; Gilard, Martine; Dupasquier, Valentin; Elhadad, Anthony; Ezzouhairi, Nacim; Clément, Arthur; Gall, Emmanuel; Henry, Patrick; Pezel, Théo. (2025). In-hospital outcomes following an acute coronary syndrome in patients with recent cannabis use.. Archives of cardiovascular diseases, 118(3), 152-160. https://doi.org/10.1016/j.acvd.2024.10.321