Abstract

Background: Following the legalization/decriminalization of recreational cannabis use in the United States, an associated increase in the cardiac-deaths has been reported. Therefore, we aimed to study the burden and healthcare disparities in major adverse cardiac and cerebrovascular events (MACCE) in cannabis use disorder (CUD)-related hospitalizations using a nationwide cohort. Methods: We queried the National Inpatient Sample (2018) to identify CUD-related adult (≥18 years old) hospitalizations and associated MACCE (all-cause mortality, acute myocardial infarction-AMI, cardiac arrest and stroke) using ICD10 diagnostic codes. We also evaluated disparities in MACCE based on sex, race, household income, and geography. Results: Of 436,440 CUD-related admissions (34±14 years, 63.4% males, 53.4% white, 30% black, and 11.2% Hispanic), 4% (n=17335) patients experience in-hospital MACCE. All MACCE events including all-cause mortality were highest among geriatric patients followed by 45-64 years and 18-44 years age group with CUD [Table 1] . There was a sex disparity with males (4.6%) having higher MACCE than females (2.9%). Blacks (4.5%) compared to whites (3.9%) demonstrated a higher overall MACCE. Asian or Pacific Islanders with CUD had overall higher rates of all-cause mortality (1%) and cardiac arrest (1%) vs. others. Lowest income quartile CUD hospitalized patients had higher MACCE than higher-income quartile (4.3 vs 3.3%). MACCE were highest in Southern hospitals (5%) with CUD-related admissions. Conclusion: Among CUD-related admissions, elderly vs. younger patients, males vs. females, black and Asians compared to whites, and lowest income quartile patients and Southern region are prone to have increased MACCE. A multitude of factors including age, sex, race, socioeconomic status, and access to health care seems to play role in MACCE incidence and its outcomes in cannabis users which warrants attention by policymakers and physicians.

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