Abstract 13841: Prevalence and Impact of Recreational Cannabis Use on Acute Ischemic Stroke and Related Mortality in Elderly (≥65 Yrs) Peripheral Vascular Disease Patients: A Population-Based Analysis in the US (2016-2019)

Abstract

Background: Considering preliminary reports suggesting associations between peripheral atherosclerotic disease (cannabis arteritis) and acute ischemic stroke (AIS) with cannabis use disorder (CUD), we sought to study the burden and impact of CUD on AIS risk and outcomes in the elderly with PVD. Methods: The National Inpatient Sample (2016-2019) was used to identify geriatric PVD admissions with vs. without CUD . We compared the burden and risk of AIS admissions with vs. without CUD and subsequent in-hospital mortality using adjusted multivariable regression analyses. Results: Of 5,115,824 total geriatric admissions with PVD (50.6% males, 77.5% white), 21,405 had CUD. The prevalence of DM was lower in the CUD cohort (19.7% vs 33.7%) with comparable rates of HTN and smoking between groups [Table 1]. Concomitant drug use was higher in CUD vs non-CUD cohort. There was AIS period prevalence of 5.2% in CUD vs 4.0% in non-CUD cohorts (p<0.001). Among geriatric PVD patients, CUD was associated with higher odds of AIS hospitalizations aOR 1.34 (95%CI 1.18-1.52, p<0.001) without a statistically significant difference in subsequent all-cause in-hospital mortality (aOR 0.71, 95%CI 0.36-1.37, p=0.302). Elderly PVD patients with HTN (aOR 1 .73) predicted higher risk of AIS, however, interestingly, concomitant tobacco use disorder revealed a paradox protective effect while assessing the predictors of AIS in elderly PVD patients with CUD (aOR 0.58 95CI 0.42-0.79, p<0.001). Conclusions: There is a 34% risk of AIS in Geriatric PVD patients with CUD even after controlling for CVD risk factors and drug abuse. Future studies are warranted to explore and confirm the observed smoker’s paradox.