Abstract 10022: Young Adults Hospitalized with Diabetes Remain at 25% Higher Risk of Acute Myocardial Infarction with Cannabis Use Disorder: A Nationwide Matched Analysis

Abstract

Background: The impact of cannabis use on diabetes mellitus and associated cardiovascular events remains understudied. Rising trends in recreational cannabis use in the young prompted us to evaluate the risk and outcomes of acute myocardial infarction (AMI) in young diabetics with cannabis use disorder (CUD). Methods: We queried the National Inpatient Sample (2015 October-2017) to identify young adult admissions with diabetes. Demographically (age, sex, and race) matched (1:1) cohorts (CUD+ vs. CUD) were compared for comorbidities and risk of AMI and subsequent inpatient outcomes among young diabetics. Multivariable regression analysis was performed adjusting for confounders. Results: Of young adults admitted with diabetes (median 35 [29-40] years, 59.3% male, 42.3% white), demographically matched CUD+ (n=32170) and CUD- (n=32170) cohorts were obtained (Table 1). The CUD+ cohort often consisted of non-elective admissions (91.7% vs. 85.45%), Medicaid enrollees (51.6% vs. 38.7%), patients from lower household income quartile (47.9% vs. 43.1%) vs. CUD- cohort and had higher burden of smoking, alcohol abuse, chronic pulmonary disease, depression, psychosis and neurological disorders (p<0.001). On adjusted multivariable analysis, the risk of AMI was 25% higher (OR:1.25, 95%CI:1.02-1.51, p=0.03) in CUD+ cohort, however, there was no significant difference in the subsequent inpatient mortality. Male sex (aOR1.35), non-elective admission (aOR2.46), Medicaid/self-pay enrollment (aOR 2.0/3.8), AIDS (aOR6.24), coagulopathy (aOR1.85), peripheral vascular disease (aOR 1.82), hypertension (aOR 2.12), hyperlipidemia (aOR2.53), smoking (aOR1.78), and obesity (aOR1.36) were independent predictors of AMI. Conclusion: Young diabetics with CUD may have 25% higher risk of AMI hospitalizations. Male sex, cardiovascular comorbidities, tobacco smoking, AIDS and coagulopathy independently predicted higher risk of AMI among young diabetics with CUD.