Contemporary nationwide trends in major adverse cardiovascular events in young cannabis users without concomitant tobacco, alcohol, cocaine use

Table 1 Baseline characteristics of young adults hospitalized with cannabis use disorder in absence of concomitant tobacco/cocaine/alcohol use disorder (2016-2019)

		2016	2017	2018	2019	Overall	P value
Age at admission, median (interquartile range)		28 (23, 44)	28 (23, 44)	28 (23, 44)	28 (23, 44)	28 (23, 44)	< 0.001
Sex	Male	58.3	57.2	56.2	55.5	56.8	< 0.001
	Female	41.7	42.8	43.8	44.5	43.2
Race	White	55.1	53.8	53.6	53.6	54.0	< 0.001
	Black	30.8	31.1	30.9	30.8	30.9
	Hispanic	11.8	12.7	13.1	13.2	12.7
	Asian/PI	1.1	1.3	1.3	1.3	1.3
	Native American	1.2	1.0	1.1	1.1	1.1
Median household income national quartile for patient ZIP code	0-25th	40.3	39.8	39.6	40.2	40.0	< 0.001
	26th-50th	25.1	26.5	27.1	25.6	26.1
	51th-75th	20.9	20.2	20.1	20.9	20.5
	76th-100th	13.7	13.5	13.2	13.3	13.4
Payer type	Medicare	9.4	9.0	8.9	8.4	8.9	< 0.001
	Medicaid	50.6	51.9	51.6	50.6	51.2
	Private	26.0	25.5	25.2	25.8	25.6
	Self-pay	13.0	12.7	13.4	14.1	13.3
	No charge	1.0	1.0	0.9	1.0	1.0
Hospital location and teaching status	Rural	8.1	8.0	7.8	7.7	7.9	< 0.001
	Urban nonteaching	24.0	20.6	18.7	16.3	19.8
	Urban teaching	67.9	71.5	73.5	75.9	72.3
Hospital region	Northeast	18.6	18.7	18.6	17.6	18.4	< 0.001
	Midwest	25.1	25.4	24.6	24.6	24.9
	South	34.3	33.4	34.3	36.0	34.5
	West	22.1	22.5	22.5	21.8	22.2
Comorbidities
Hypertension		15.7	15.9	16.2	16.3	16.0	< 0.001
Diabetes		7.4	8.0	7.9	8.2	7.9	< 0.001
Hyperlipidemia		4.5	4.7	4.8	5.1	4.8	< 0.001
Obesity		9.0	9.7	10.0	10.6	9.8	< 0.001
Peripheral vascular disease		0.7	0.7	0.7	0.8	0.7	< 0.001
Prior MI		0.8	0.8	0.8	0.8	0.8	0.187
Prio stroke/transient ischemic attack		0.9	0.9	1.0	0.9	0.9	0.004
Chronic pulmonary disease		12.7	13.1	12.8	12.9	12.9	< 0.001
Hypothyroidism		2.4	2.3	2.3	2.5	2.4	0.001
Other thyroid disorders		0.6	0.7	0.7	0.8	0.7	< 0.001
Valvular heart disease		0.3	0.3	0.3	0.3	0.3	0.054
Cancer		1.0	1.0	1.0	1.0	1.0	0.147

P < 0.05 indicate statistical significance. MI: Myocardial infarction.

Table 2 Multivariable analysis of major adverse cardiac and cerebrovascular events-related admissions in young adults with dependent cannabis use in the absence of concomitant tobacco, alcohol, or cocaine use disorder with calendar year 2016-2019

In hospital outcomes	Odds ratio	Lower 95%CI	Upper 95%CI	P value
Major adverse cardiac and cerebrovascular events	1	0.96	1.03	0.818
All-cause mortality	0.98	0.91	1.06	0.623
Acute myocardial infarction	1.04	1	1.09	0.077
Cerebral vascular	0.96	0.88	1.03	0.252
Acute ischemic stroke	0.97	0.92	1.03	0.332

Multivariable analysis was adjusted for factors like age, payer type, race, median household income, acquired immune deficiency syndrome, depression, chronic pulmonary disease, obesity, diabetes mellitus, hypertension, hepatolenticular degeneration, peripheral vascular disease, cancer, prior stroke/transient ischemic attack, prior myocardial infarction. P < 0.05 considered significant.