Abstract

Introduction: The prevalence of cannabis use disorder (CUD) has increased in the US especially following its legalization in various states. Few studies have reported that CUD has been associated with increased Acute Myocardial Infarction (AMI) especially in the younger population. There are limited epidemiological studies that estimate the recent trend of AMI among young patients with CUD. Hypothesis: To estimate the hospitalization trends of AMI with concurrent CUD and characteristics associated with it in the young population. Methods: Study cohort was derived from the National Inpatient Sample (NIS) for the years 2007-2018. Hospitalizations due to AMI among the age group of 18-49 and concurrent CUD were identified using previously validated ICD-9-CM/ICD-10-CM. We then utilized the Cochran Armitage trend test and multivariable survey logistic regression modeling to analyze temporal trends and predictors of CUD among AMI patients. Results: Out of a total 819,354 hospitalizations due to AMI among the age group of 18-49 years, 33,488 (4.1%) had concurrent CUD. Hospitalizations due to AMI with concurrent CUD increased from 1722 (2.4%) in 2007 to 4455 (6.7%) in 2018 with a 12% yearly rate (OR 1.1; 95%CI 1.1-1.1; p<0.01). AMI patients with CUD were younger (20.2% vs 7.3%; p<0.01), male (78.1.2% vs 71.6%; p<0.01) and African American (35.2% vs 15.8%; p<0.01). In multivariable regression analysis, age 18-34 (OR 2.9; 95% CI 2.7 - 3.1; P<0.01), male (OR 1.5; 95%CI 1.4 - 1.6; p<0.01), African American (OR 2.5; 95% CI 2.4-2.7, p<0.01), Lower socio-economic status (OR 1.3; 95% CI 1.1-1.4, p<0.01), West region (OR 1.3; 95% CI 1.2-1.5, p<0.01), depression (OR 1.2; 95% CI 1.1-1.3, p <0.01), alcoholism were associated with higher odds of CUD and AMI. Moreover, AMI patients with CUD were more likely to be admitted during the weekend (OR 1.1; CI 1.1-1.1, p <0.01). Conclusions: Our study highlights the increasing trend of AMI hospitalizations with concurrent CUD. Our study also identifies that 18-34 years of age, male gender, African American and psychiatric conditions were significant determinants of CUD in young AMI patients. This warrants additional research to prove causal association between CUD and AMI in the young population in the era of increased cannabis legalization.

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