Cannabis, cocaine, methamphetamine, and opiates increase risk of atrial fibrillation

A recent study published in the European Heart Journal reveals that using illicit drugs can increase atrial fibrillation risk.

Study: Cannabis, cocaine, methamphetamine, and opiates increase the risk of incident atrial fibrillation. Image Credit: Lightspring / Shutterstock

Background

Atrial fibrillation is a common cardiac disease characterized by rapid and irregular heart rate, leading to blood clot formation in the heart and impairment in blood flow. The disease is associated with significant morbidity and mortality. Therapeutic interventions primarily focus on correcting heart rate and rhythm and triggering the anticoagulation process to prevent cardioembolic stroke.

Several modifiable risk factors, such as alcohol and tobacco use, have been identified to prevent atrial fibrillation. However, not enough evidence is available regarding the association between the use of illicit drugs and disease risk. The legalization of cannabis and relaxation in laws regarding other illicit drugs have made it necessary to understand the impact of commonly consumed drugs on the incidence of atrial fibrillation.

In the current study, scientists have evaluated whether the use of methamphetamine, cocaine, opiates, and cannabis increases the risk of atrial fibrillation in adult residents of California, USA.

Study design

The scientists used California health department databases to identify all adult residents of the state who received medical care in emergency departments, ambulatory surgery facilities, or hospitals between 2005 and 2015.

Four illicit drugs, including methamphetamine, cocaine, opiate, and cannabis, were considered in the study. The impact of each drug use on a new atrial fibrillation diagnosis was assessed.

Important observations

A total of 23,561,884 patients were included in the analysis. Of them, 98,271 used methamphetamine, 48,701 used cocaine, 10,032 used opiates, and 132,834 used cannabis. Approximately 4.2% of the patients developed incident atrial fibrillation during the study period.   

Impact of illicit drug use on atrial fibrillation risk

The impact of each tested drug as an independent predictor of atrial fibrillation was assessed after adjusting for several known demographic (age, sex, race, and income), clinical (hypertension, dyslipidemia, diabetes mellitus, coronary artery disease, congestive heart failure, valvular heart disease, obesity, obstructive sleep apnea, and chronic kidney disease), and other modifiable (alcohol and tobacco use) risk factors. 

The findings revealed that the use of each tested drug is associated with an increased risk of atrial fibrillation. The highest and lowest associations were observed for methamphetamine and cannabis, respectively.

The association between methamphetamine use and atrial fibrillation risk was similar or greater to that observed for many known risk factors in the databases. Similarly, despite having the lowest impact compared to other tested drugs, the association between cannabis use and atrial fibrillation was comparable to that observed for dyslipidemia, diabetes mellitus, and chronic kidney disease.    

The patients who used multiple drugs exhibited a higher risk of atrial fibrillation than those who used a single drug.

The severity of drug use was assessed by creating five clinical categories: drug dependence, continuous drug intake, episodic drug intake, in remission drug intake, and adverse effects in therapeutics. An independent association was observed between each clinical category and increased risk of atrial fibrillation.

Study significance

The study identifies methamphetamine, cocaine, opiate, and cannabis as independent predictors of incident atrial fibrillation among adult residents of California. Since the consumption of illicit drugs is a modifiable risk factor, efforts to reduce the use of these drugs could be beneficial in terms of reducing the risk of atrial fibrillation.

As mentioned by the researchers, further studies are required to understand the modes of action of these drugs in causing cardiac abnormalities.

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.