Abstract 14449: Not So Harmless: Marijuana Use and In-hospital Outcomes After Percutaneous Coronary Intervention: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

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Introduction: Marijuana use is increasing as more states are legalizing it for both recreational and medicinal uses. Although studies have suggested an association between marijuana use and cardiovascular risk, there are limited data on outcomes after percutaneous coronary intervention (PCI) among marijuana users. Hypothesis: We hypothesize that marijuana users are at an increased risk of adverse outcomes after PCI compared with non-users. Methods: Between 1/1/2013 and 10/1/2016, self-reported marijuana use was collected by the Blue Cross Blue Shield Michigan Cardiovascular Consortium (BMC2), a state-wide registry of all patients who underwent PCI at 48 non-federal hospitals in Michigan. In-hospital outcomes included post-procedural stroke, transfusion, bleeding, acute kidney injury (AKI), and death. We used 1:1 propensity matching and multivariable logistic regression techniques to adjust for differences in baseline characteristics between marijuana users and non-users. Results: Among 113,477 patients, 3,970 (3.5%) self-identified as marijuana users. Compared with non-users, marijuana users were more likely to be younger (53.9 vs. 65.8), male (79.2% vs 66.8%), cigarette smokers (73.0% vs. 26.8%), present with ST-elevation myocardial infarction (27.3% vs. 15.9%), and have fewer cardiovascular comorbidities. After matching (n=3,803 per group), compared with non-users, marijuana users had significantly increased risks of bleeding (5.2% vs. 3.4%; aOR 1.54 [1.20-1.97], p<0.001) and stroke (0.3% vs 0.1%; aOR 11.01 [1.32-91.67]; p=0.026), and a decreased risk of AKI (2.2% vs 2.9%; aOR 0.61 [0.42-0.87]; p = 0.007). There were no differences in the risks of transfusion or death. Conclusions: Marijuana use was associated with significantly increased risks of stroke and bleeding after PCI. As marijuana use continues to grow, clinicians and patients should be aware of the increased risks of post-PCI complications in these patients.