Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cocaine & Marijuana Use in Young Adults with MI

J Am Coll Cardiol; ePub 2018 Mar 10; DeFilippis, et al

Cocaine and/or marijuana use is present in 1 of 10 patients with a myocardial infarction (MI) aged ≤50 years and is associated with worse all-cause and cardiovascular (CV) mortality, a recent study found. The retrospective study analyzed records of patients presenting with a Type 1 MI at ≤50 years at 2 academic hospitals from 2000 to 2016. Researchers determined:

  • Among 2,097 patients with Type 1 MI (mean age 44±5.1 years, 19.3% female, 73% white) with median follow-up of 11.2 years, 224 (10.6%) used cocaine and/or marijuana.
  • Substance abuse was associated with significantly higher CV and all-cause mortality despite lower prevalence of traditional risk factors.
  • Those with substance use had significantly lower rates of diabetes and hyperlipidemia but were significantly more likely to use tobacco.
  • Young adults with MI should be screened for substance abuse to stratify risk.


DeFilippis EM, Singh A, Divakaran S, et al. Cocaine and marijuana use among young adults presenting with myocardial infarction: The Partners YOUNG-MI Registry. [Published online ahead of print March 10, 2018]. J Am Coll Cardiol. doi:10.1016/j.jacc.2018.02.047.