Abstract WP151: Prevailing Income-Based Disparities in Acute Ischemic Stroke and Cardiovascular Events in Young Hospitalized Adults With Cannabis Use Disorder: Insights From a Population-Based Analysis

Abstract

Introduction: Cannabis use and low socioeconomic status are recognized as distinct risk factors for stroke and cardiovascular pathologies. This observational study aims to investigate the association between income status in acute ischemic stroke (AIS) and cardiovascular events among young, hospitalized adults with dependent cannabis use or cannabis use disorder (CUD). Methods: We analyzed young adult hospitalizations (18-44 years) with known CUD from the 2020 National Inpatient Sample. Propensity score-matched analysis (1:1) was used to compare comorbidities, including AIS and cardiovascular events, between the high-income quartile (HIQ) and low-income quartile (LIQ) within the CUD cohort. Results: Out of the young adult admissions, a total of 286,855 individuals were identified as dependent cannabis users. After propensity matching, we divided the CUD cohort into 63,355 patients with HIQ (41.1% female) and LIQ (41.4% female). While both cohorts exhibited comparable ages and racial distribution (>65% white), the individuals from LIQ cohort were predominantly from South (45.7% vs. 27.9%), visiting rural hospitals (13.9% vs. 1.3%), with Medicaid (56.3% vs. 41.1%) as the predominant payer. Additionally, LIQ cohort had a higher prevalence of drug abuse (65.5% vs. 58.4%), tobacco use (24.9% vs. 22.6%), HTN (17% vs. 14.7%), chronic pulmonary disease (13.2% vs. 12.7%), DM (8% vs. 6.6%), and obesity (10.9% vs. 10.0%). Additionally, in-hospital outcomes like AIS (0.5% vs. 0.3%) and MACCE (2% vs. 0.8%) were higher in the LIQ cohort. After adjusting for confounding factors, the risk of AIS in the HIQ cohort was 37% lower than in the LIQ cohort (OR: 0.63 [95% CI: 0.42-0.96]). (all-p<0.05). Conclusion: Higher prevalence of CVD risk factors in the LIQ-CUD group and lower odds of AIS-related admissions in the HIQ-CUD group warrant targeted interventions and policy measures to understand and address behavioral risk of cannabis use by economic status and disparities in MACCE.