Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2024; 16(9): 512-521
Published online Sep 26, 2024. doi: 10.4330/wjc.v16.i9.512
Contemporary nationwide trends in major adverse cardiovascular events in young cannabis users without concomitant tobacco, alcohol, cocaine use
Rupak Desai, Priyatham Gurram, Adil S Mohammed, Rishabh B Salian, Shanmukh Sai Pavan Lingamsetty, Sandeep Guntuku, Ravi Venkata Sai Krishna Medarametla, Rawnak Jahan, Zainab Muslehuddin, Paritharsh Ghantasala
Rupak Desai, Department of Outcomes Research, Independent Researcher, Atlanta, GA 30033, United States
Priyatham Gurram, Adil S Mohammed, Paritharsh Ghantasala, Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, United States
Rishabh B Salian, Department of Medicine, Kasturba Medical College, Mangalore 575001, India
Shanmukh Sai Pavan Lingamsetty, Sandeep Guntuku, Ravi Venkata Sai Krishna Medarametla, Department of Medicine, Mamata Medical College, Khammam 507002, India
Rawnak Jahan, Department of Medicine, Bangladesh Medical College, Dhaka 110015, Bangladesh
Zainab Muslehuddin, Department of Internal Medicine, Wayne State University, Sinai Grace Hospital, Detroit Medical Center, Detroit, MI 48201, United States
Co-first authors: Rupak Desai and Priyatham Gurram.
Author contributions: Desai R was responsible for conceptualization, methodology, software, formal analysis, resources, data curation, and project administration; Gurram P, Mohammad AS, Salian RB, Lingamsetty SSP, Guntuku S, Medarametla RVSK, Muslehuddin Z, Ghantasala P, and Jahan P were responsible for writing, original draft; Desai R, Gurram P, Mohammad AS, and Ghantasala P were responsible for writing, original draft, writing, review, editing, and visualization; all authors contributed to the article and approved the submitted version.
Institutional review board statement: This manuscript is exempt from Institutional Review Board Approval Form or Document since National Inpatient Sample database was used to draw specific patient samples. The National (Nationwide) Inpatient Sample (NIS) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The NIS is the largest publicly available all-payer inpatient healthcare database designed to produce U.S. regional and national estimates of inpatient utilization, access, cost, quality, and outcomes. Unweighted, it contains data from around 7 million hospital stays each year. Weighted, it estimates around 35 million hospitalizations nationally. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality (AHRQ), HCUP data inform decision making at the national, State, and community levels.
Informed consent statement: Consent from patient was not needed as the data used has unidentified information.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest regarding the publication of this manuscript.
Data sharing statement: The data utilized in this study were derived from the National Inpatient Sample (NIS) database, which is publicly available and can be accessed through the Healthcare Cost and Utilization Project (HCUP) website (https://www.hcup-us.ahrq.gov/). Due to the nature of the NIS database, which includes de-identified patient information, there are no restrictions on data access.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paritharsh Ghantasala, FACP, MD, Assistant Professor, Department of Internal Medicine, Central Michigan University College of Medicine, 1000 Houghton Avenue, Saginaw, MI 48602, United States. paritharshghantasala@gmail.com
Received: May 14, 2024
Revised: July 26, 2024
Accepted: August 7, 2024
Published online: September 26, 2024
Processing time: 128 Days and 7.1 Hours
Abstract
BACKGROUND

Cannabis use has increased among young individuals in recent years. Although dependent cannabis use disorder (CUD) has been associated with various cardiac events, its effects on young adults without concurrent substance use remain understudied.

AIM

To examine trends in hospitalizations for major adverse cardiac and cerebrovascular events (MACCE) in this cohort.

METHODS

We used the National Inpatient Sample (2016-2019) to identify hospitalized young individuals (18-44 years), excluding those with concurrent substance usage (tobacco, alcohol, and cocaine). They were divided into CUD+ and CUD-. Using International Classification of Diseases-10 codes, we examined the trends in MACCE hospitalizations, including all-cause mortality (ACM), acute myocardial infarction (AMI), cardiac arrest (CA), and acute ischemic stroke (AIS).

RESULTS

Of 27.4 million hospitalizations among young adults without concurrent substance abuse, 4.2% (1.1 million) had co-existent CUD. In CUD+ group, hospitalization rates for MACCE (1.71% vs 1.35%), AMI (0.86% vs 0.54%), CA (0.27% vs 0.24%), and AIS (0.49% vs 0.35%) were higher than in CUD- group (P < 0.001). However, rate of ACM hospitalizations was lower in CUD+ group (0.30% vs 0.44%). From 2016 to 2019, CUD+ group experienced a relative rise of 5% in MACCE and 20% in AMI hospitalizations, compared to 22% and 36% increases in CUD- group (P < 0.05). The CUD+ group had a 13% relative decrease in ACM hospitalizations, compared to a 10% relative rise in CUD- group (P < 0.05). However, when adjusted for confounders, MACCE odds among CUD+ cohort remain comparable between 2016 and 2019.

CONCLUSION

The CUD+ group had higher rates of MACCE, but the rising trends were more apparent in the CUD- group over time. Interestingly, the CUD+ group had lower ACM rates than the CUD- group.

Keywords: Cannabis; Major adverse cardiac and cerebrovascular events; Myocardial infarction; Cardiac arrest; Stroke; All-cause mortality; Young adults; Trends

Core Tip: Higher rates of major adverse cardiac and cerebrovascular events were observed in young adults with cannabis use disorder (CUD), while noting a relative decrease in all-cause mortality hospitalizations compared to those without CUD.