Patients with a history of marijuana use show significantly greater coronary artery plaque burden on CT angiography than nonusers, suggests research presented July 10 at the Society of Cardiovascular Computed Tomography (SCCT) meeting. 

The single-center study found that marijuana users had higher calcium scores, greater total plaque volume, and more frequent significant stenosis than those without a history of use, noted presenter Stephen Foley, MD, of the University of Massachusetts in Worcester, and colleagues. 

“Marijuana use has increased substantially in the United States over the past decade; however, its association with coronary atherosclerosis is poorly understood,” the group wrote. 

Prior studies evaluating cardiovascular risk in marijuana users have largely focused on clinical or epidemiologic outcomes rather than direct imaging-based assessment of coronary plaque, the researchers noted. To bridge the gap, the group evaluated the association between marijuana use and coronary atherosclerosis using quantitative plaque analysis from coronary CT angiography (CCTA). 

The researchers analyzed data using HeartFlow Plaque Analysis software (HeartFlow, Mountain View, CA) from patients aged 30 to 75 years old who underwent CCTA and coronary artery calcium (CAC) scoring, with subjects categorized by reported history of current or prior marijuana use (n=24) versus those without (n=27). Baseline characteristics were generally well-balanced, although marijuana users displayed higher rates of tobacco use history (79.2% vs 3.7%, p

According to the results, marijuana users demonstrated more than double CAC scores than nonusers (median: 274.1 vs 126.2, p = 0.013). CCTA plaque analysis supported that marijuana users had significantly higher total plaque volume (747.7 vs 202, p = 0.005) and significant stenosis (70.8% vs 29.6%, p = 0.003). In addition, marijuana users more often received an escalation of current statin, while nonusers were more likely to initiate a new agent, the researchers reported. 

“Marijuana use was associated with significantly greater coronary plaque burden and calcification on CCTA-derived quantitative plaque analysis, suggesting a potential relationship between marijuana smoking and accelerated coronary atherosclerosis,” the group wrote.  

Ultimately, early cardiovascular risk assessment and optimization of preventive therapy may be key considerations in patients with a history of marijuana use, the researchers concluded.