Abstract 13741: Impact Of Cannabis Use Disorder On Outcomes Of Hospitalization Due To Acute Myocardial Infarction

Abstract

Background: The prevalence of cannabis use disorder (CUD) has increased in the US especially following its legalization in various states. Few smaller studies have reported that CUD has been associated with increased Acute Myocardial Infarction (AMI) but reduced mortality. There is limited and inconclusive literature on the impact of concurrent CUD on AMI outcomes especially in the younger population. Hypothesis: To estimate the impact of CUD on hospitalizations due to AMI in the young population from the largest available database. Methods: We derived a study sample from the National Inpatient Sample (NIS) for the years 2007-2018. Hospitalizations due to AMI among the age group of 18-49 were identified using previously validated ICD-9-CM/ICD-10-CM. Cannabis use disorder and other diagnosis of interests were identified by ICD-9/10-CM codes. Primary outcome of interest was in-hospital mortality. We then utilized the Cochran Armitage trend test and multivariable survey logistic regression modeling to analyze impact of CUD on AMI outcomes. Results: Out of a total 819,354 hospitalizations due to AMI among the young population, 33,488 (4.1%) had concurrent CUD. AMI patients with CBD were younger (40 vs 44 years; p<0.01), male (78.1.2% vs 71.6%; p<0.01) and African American (35.2% vs 15.8%; p<0.01). CUD was also associated with lower utilization of PCI (OR 0.9; 95%CI 0.9-0.9; p:0.03). There was no significant difference in CABG utilization, mechanical ventilation requirement and cardiac arrest in patients with and without CUD. In-hospital mortality was lower in the CUD group as compared to non-CUD (1.3 vs 1.7; p<0.01). After adjusting with patient and hospital level characteristics, comorbidities and confounding factors, CUD was associated with lower in-hospital mortality (OR 0.7; 95%CI 0.6-0.9; p<0.01) and discharge to facilities (OR 0.9; 95%CI 0.8-0.9; p:0.02). Conclusion: Our study found lower PCI utilization as well as lower in-hospital mortality and discharge to facilities among the young AMI patients with CUD. Our study cannot establish causal relationship and further studies are required for in-depth exploration and identify possible mechanisms of cannabis on myocardial infarction and its severity.