Abstract
Background and objectives: Modern-day epidemiologic data on the risk and shifting landscape of occurrence of cardiovascular events in cannabis users remain inadequate and rather conflicting, especially amongst the young adult population. Furthermore, the problem of polysubstance use among youth is challenging for healthcare professionals and policy-makers. Previous studies report higher risk of concomitant use of tobacco, alcohol, cocaine, and amphetamine in young cannabis users. However, most of these studies did not eliminate the confounding effects of concomitant other substance abuse while assessing the incidence and outcome of cardiovascular events in cannabis users. Materials and methods: Using weighted discharge records from the National Inpatient Sample (NIS) from 2007–2014, we assessed the national trends in hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users (18–39 years), excluding cases with concomitant substance abuse with alcohol, tobacco, cocaine, and amphetamine. Results: Of 52.3 million hospitalizations without other substance abuse, 0.7 million (1.3%) young adults were current/former cannabis users. Among young adults without concomitant substance abuse, the frequency of admissions for AMI (0.23% vs. 0.14%), arrhythmia (4.02% vs. 2.84%), and stroke (0.33% vs. 0.26%) was higher in cannabis users as compared to non-users (p < 0.001). However, the frequency of admissions for VTE (0.53% vs. 0.84%) was lower among cannabis users as compared non-users. Between 2007 and 2014, we observed 50%, 79%, 300%, and 75% relative increases in hospitalizations for AMI, arrhythmias, stroke, and VTE, respectively, among young cannabis users as compared to non-users, showing relatively inferior or no ascent in the rates (ptrend < 0.001). Conclusions: The rising trends in hospitalizations for acute cardiovascular events among young cannabis users without concomitant other substance abuse call for future prospective well-designed studies to assess cannabis-related short-and long-term cardiovascular implications while simultaneously developing focused interventions towards raising awareness among the young population regarding the potential deleterious effects of cannabis use.
Highlights
Amidst legalization and decriminalization of recreational and medical use, cannabis has garnered numerous new users over the past few years and its usage is expected to rise even further by youth in the near future [1,2]
A few studies have evaluated the association of cannabis use, cardiovascular diseases (CVD), and stroke in hospitalized patients [1,6,7,8,9]; even so, most of these studies did not examine the confounding effect of other substance abuse like tobacco, alcohol, or stimulant substances like cocaine or amphetamine, we proposed to assess the national trends in the hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users of age 18–39 years, while excluding hospitalizations with concurrent history of other substance abuse
We identified a total of 52,290,927 United States (US) nationwide hospitalizations among young patients
Summary
Amidst legalization and decriminalization of recreational and medical use, cannabis (marijuana) has garnered numerous new users over the past few years and its usage is expected to rise even further by youth in the near future [1,2]. A few studies have evaluated the association of cannabis use, CVD, and stroke in hospitalized patients [1,6,7,8,9]; even so, most of these studies did not examine the confounding effect of other substance abuse like tobacco, alcohol, or stimulant substances like cocaine or amphetamine, we proposed to assess the national trends in the hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users of age 18–39 years, while excluding hospitalizations with concurrent history of other substance abuse. Materials and methods: Using weighted discharge records from the National Inpatient Sample (NIS) from 2007–2014, we assessed the national trends in hospitalizations for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, stroke, and venous thromboembolic events (VTE) among young cannabis users (18–39 years), excluding cases with concomitant substance abuse with alcohol, tobacco, cocaine, and amphetamine. Results: Of 52.3 million hospitalizations without other substance abuse, 0.7 million (1.3%) young adults were current/former cannabis users
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