Cannabis is increasingly used for therapeutic purpose. However, its safety profile is not well known. This study assessed the risk of cardiovascular-related emergency department (ED) visit and hospitalization in adult patients authorized to use medical cannabis in Ontario, Canada from 2014 to 2017. This is a longitudinal cohort study of patients who received medical cannabis authorization and followed-up in cannabis clinics, matched to population-based controls. The primary outcome was an ED visit or hospitalization for acute coronary syndrome (ACS) or stroke; and secondary outcome was for any cardiovascular event. Conditional Cox proportional hazards regression was used to assess the association between cannabis authorization and risk. 18,653 cannabis patients were matched to 51,243 controls. During a median follow-up of 242 days, the incidence rates for ACS or stroke were 7.19/1000 person-years and 5.67/1000 person-years in the cannabis and controls group, respectively- adjusted hazard ratio (aHR) of 1.44 (95% CI 1.08–1.93). When stratified by sex, the association was only statistically significant among males: aHR 1.77 (1.23–2.56). For the secondary outcome (any CV events), the aHR was 1.47 (1.26–1.72). The aHR among males and females were 1.52 (1.24–1.86) and 1.41 (1.11–1.79), respectively. Tested interaction between cannabis authorization and sex was not significant (p > 0.05). Medical cannabis authorization was associated with an increased risk of ED visits or hospitalization for CV events including stroke and ACS.

中文翻译：

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医用大麻授权与心血管事件风险：一项纵向队列研究

大麻越来越多地用于治疗目的。然而，它的安全性并不为人所知。本研究评估了 2014 年至 2017 年在加拿大安大略省获准使用医用大麻的成年患者的心血管相关急诊科 (ED) 就诊和住院风险。这是一项对获得医​​用大麻授权并随访的患者的纵向队列研究 -在大麻诊所，与基于人群的控制相匹配。主要结局是急诊科就诊或因急性冠状动脉综合征（ACS）或中风住院；次要结局是任何心血管事件。条件 Cox 比例风险回归用于评估大麻授权与风险之间的关联。18,653 名大麻患者与 51,243 名对照者相匹配。在 242 天的中位随访期间，大麻组和对照组的 ACS 或中风发病率分别为 7.19/1000 人年和 5.67/1000 人年，调整后的风险比 (aHR) 分别为 1.44 (95% CI 1.08–1.93)。按性别分层时，该关联仅在男性中具有统计学意义：aHR 1.77 (1.23–2.56)。对于次要结果（任何 CV 事件），aHR 为 1.47 (1.26–1.72)。男性和女性的 aHR 分别为 1.52 (1.24-1.86) 和 1.41 (1.11-1.79)。测试大麻授权与性别之间的相互作用不显着（p > 0.05）。医用大麻授权与心血管事件（包括中风和 ACS）的 ED 就诊或住院风险增加有关。分别调整后的风险比 (aHR) 为 1.44 (95% CI 1.08–1.93)。按性别分层时，该关联仅在男性中具有统计学意义：aHR 1.77 (1.23–2.56)。对于次要结果（任何 CV 事件），aHR 为 1.47 (1.26–1.72)。男性和女性的 aHR 分别为 1.52 (1.24-1.86) 和 1.41 (1.11-1.79)。测试大麻授权与性别之间的相互作用不显着（p > 0.05）。医用大麻授权与心血管事件（包括中风和 ACS）的 ED 就诊或住院风险增加有关。分别调整后的风险比 (aHR) 为 1.44 (95% CI 1.08–1.93)。按性别分层时，该关联仅在男性中具有统计学意义：aHR 1.77 (1.23–2.56)。对于次要结果（任何 CV 事件），aHR 为 1.47 (1.26–1.72)。男性和女性的 aHR 分别为 1.52 (1.24-1.86) 和 1.41 (1.11-1.79)。测试大麻授权与性别之间的相互作用不显着（p > 0.05）。医用大麻授权与心血管事件（包括中风和 ACS）的 ED 就诊或住院风险增加有关。79），分别。测试大麻授权与性别之间的相互作用不显着（p > 0.05）。医用大麻授权与心血管事件（包括中风和 ACS）的 ED 就诊或住院风险增加有关。79），分别。测试大麻授权与性别之间的相互作用不显着（p > 0.05）。医用大麻授权与心血管事件（包括中风和 ACS）的 ED 就诊或住院风险增加有关。