Abstract 13028: Cannabis Use Disorder Adversely Affects Outcomes of Diabetics Hospitalized With Prior Myocardial Infarction and Revascularization: A National Propensity-Matched Analysis

Abstract

Background: Increasing unmonitored use of recreational cannabis in the United States is alarming especially among patients with known cardiovascular disease (CVD) risk. Considering mixed reports of cannabis use and its impact on diabetes mellitus and associated outcomes, we aimed to assess the impact of cannabis use disorder (CUD) on outcomes of diabetics hospitalized with prior myocardial infarction (MI) and revascularization [PCI and/or CABG]. Methods: We queried the National Inpatient Sample (2015Oct-2017Dec) to identify admissions among diabetics with prior revascularized MI and CUD. Propensity score-matched analysis (1:1) was performed adjusting for demographic and hospital characteristics to obtain CUD+ & CUD- cohorts which were then compared for comorbidities and in-hospital outcomes. Primary outcomes were major adverse cardiac and cerebrovascular events (MACCE: all-cause mortality, acute MI, cardiac arrest and stroke) and subsequent revascularization and secondary outcomes were median hospital stay and charges. Results: Each diabetic cohort with prior MI and revascularization consisted of 190 patients with and without CUD (CUD+ vs. CUD-). Both matched cohorts were comparable in terms of demographics (Table 1) and had balanced distribution of most of the CVD risk factors except hypertension (92.1% vs. 97.4%; p=0.022) and renal failure (18.4% vs. 28.9%; p=0.016) which were lower in the CUD+ cohort. The rates of MACCE (28.9% vs. 10.5%) and revascularization (23.7% vs. 7.9%, p<0.001) were significantly higher in the CUD+ cohort (p<0.001). Furthermore, the CUD+ cohort was less often routinely discharged (63.2% vs. 76.3%) with higher length of stay (4 vs. 3 days) and hospital charges. Conclusion: This nationwide propensity-matched analysis revealed that the CUD increases the rates of MACCE, subsequent revascularization with higher healthcare resource utilization in diabetics hospitalized with a prior history of MI and revascularization.