Abstract 11349: Substance Use and Associated Risk of Incident Atrial Fibrillation

Abstract

Introduction: Atrial fibrillation (AF) is a common arrythmia associated with high morbidity and mortality. Understanding modifiable risk factors that contribute to AF could have a broad impact on patient outcomes. While work has been done to understand the association between alcohol use and AF, there is limited understanding in the relationship between non-alcohol substance use and new-onset AF. Our study sought to investigate the associations of methamphetamine, cocaine, opiate, and cannabis use with incident AF. Methods: This is a retrospective observational study of 23,561,844 adult inpatient hospitalizations and ED visits from January 1, 2005 to September 30, 2015 in California’s Office of Statewide Health Planning and Development (OSHPD) database. International Classification of Disease (ICD) codes were used to document AF and methamphetamine, cocaine, opiate, or cannabis use disorders. All patients with prevalent AF were excluded from analysis. Results: Methamphetamine use (n=98,271), cocaine use (n=48,700), opiate use (n=10,032), and cannabis use (n=132,834) disorders were coded as part of routine clinical care. In multivariate analysis adjusting for age, race, sex, income, and cardiovascular risk factors, methamphetamine, cocaine, opiate, and cannabis use were associated with higher incidence of AF ( Table ). The cumulative probability of incident AF increased over time with all four substances ( Figure ). Conclusion: Patients with documented methamphetamine, cocaine, opiate, or cannabis use disorders had an increased risk of incident AF that was independent of the risk already portended by established cardiovascular risk factors.