Abstract 11657: Cannabis Use is Associated With Abnormal P-wave Axis

Abstract

Introduction: Cannabis use has been linked to incident ischemic cerebrovascular disease (CVA) and atrial arrhythmias in various case series and population studies. Hypothesis: Cannabis is independently associated with abnormal p-wave axis (aPWA), a marker of atrial myopathy. Methods: This analysis included 3,600 (age 48.2 ± 5.9 years, 47.6% male, 69.1% whites) participants from the Third National Health and Nutrition Examination Survey. Cannabis use was defined by self-report. aPWA was defined as p-wave axis outside of 0-75 degrees. Multivariable logistic regression was used to examine the association between cannabis use and aPWA. The consistency of this association was tested among subgroups stratified by demographic and comorbid covariates. Results: About 24.3% (n = 875) of participants were ever-cannabis users and 20.4% (n = 735) had aPWA. In multivariable and logistic regression analysis, ever- and former cannabis users had increased odds of aPWA compared to never users [OR (95% CI): 1.27 (1.03-1.56) and 1.28 (1.03-1.59), respectively]. Those reporting ≥10 lifetime uses had 40% increased odds of aPWA [OR (95% CI): 1.40 (1.07-1.84)]. This effect was stronger among ever-users with a history of cardiovascular (CV) disease versus those without [OR (95% CI): 4.11, 95% CI: 1.35 - 12.52, interaction p-value 0.03]. Conclusion: Cannabis use is associated with atrial myopathy reflected as aPWA. This association is stronger among participants with a history of CV disease. These findings underscore a potential mechanism by which cannabis use increases the risk for ischemic CVA/atrial arrhythmias and highlights the need for personalized cannabis risk assessment.