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Coronary thrombosis and marijuana smoking: a case report and narrative review of the literature
Author(s) -
Marchetti Daniela,
Spagnolo Angelico,
De Matteis Valentino,
Filograna Laura,
De Giovanni Nadia
Publication year - 2016
Publication title -
drug testing and analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.065
H-Index - 54
eISSN - 1942-7611
pISSN - 1942-7603
DOI - 10.1002/dta.1898
Subject(s) - medicine , cannabinol , myocardial infarction , cannabis , cannabinoid , circumstantial evidence , narrative review , tetrahydrocannabinol , intensive care medicine , psychiatry , receptor , political science , law
We encountered evidence of myocardial infarction due to coronary thrombosis in an autopsy of an occasional marijuana smoker. These findings prompted us to perform a narrative review of the literature to determine when post‐mortem toxicological tests may support a temporal relationship between marijuana smoking and cardiovascular disease. Toxicological examination showed the presence of Δ‐9‐tetrahydrocannabinol, its main metabolite and cannabinol in blood and urine. Quali‐quantitative analysis revealed that Δ‐9‐tetrahydrocannabinol was taken within 2 h of the onset of cardiovascular symptoms, according to circumstantial data. Post‐mortem toxicological results must take into account the degradation and post‐mortem redistribution of analytes. However, for any inference about the specific cardiovascular triggering effect of Δ‐9‐tetrahydrocannabinol intake, we maintain that cannabinoid analysis in blood samples must be considered an essential requirement to estimate the time of last intake and avoid incomplete documentation. The literature, combined with the present case report, highlights an association between marijuana use and negative cardiovascular events, although few authors have supported their conclusions with toxicological results. Thus, additional research is needed. Copyright © 2015 John Wiley & Sons, Ltd.