Abstract 4120496: Cannabis Use Among Heart Failure Hospitalizations and Cardiovascular Outcomes. A Five-Year Retrospective Study

Introduction: The use of cannabis is on the rise. A few retrospective studies have demonstrated an association between cannabis use and ischemic heart disease and stroke. However, its implications in the already established heart failure (HF) population has not been well studied. We aimed to address this gap. Methods: We employed the National Inpatient Sample database (2016-2020) and used ICD-10 codes to identify all patients ≥18 years old with a history of HF. Then, we divided them into two groups: those with and without a history of cannabis use. A greedy nearest-neighbor 1:1 propensity score matching (PSM) followed by multivariable logistic regression analysis was used to account for baseline differences (including cigarette smoking) and to predict the outcomes. The outcomes were ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), uncontrolled hypertension (HTN), arrhythmias, acute kidney injury (AKI), and stroke. Results: Of the 4,283,620 HF hospitalizations, 1.6% (67,795) used cannabis, and 72% (48,825) were male. Compared to the non-cannabis group, the group with cannabis use was younger, with a mean age of 53 vs 68 years, p<0.0001. After PSM, 56,233 with a history of cannabis use were matched to 56,233 hospitalizations without cannabis use history. The population with cannabis use had a higher association with uncontrolled HTN 1.5 (1.4-1.6), NSTEMI 1.3 (1.23-1.36), STEMI 1.15 (1.05-1.25), stroke 1.14 (1.05-1.23), and AKI 1.05 (1.02-1.1), (p<0.0001, for each). Arrhythmias 0.96 (0.94-1.01, p=0.1) did not differ between both groups. Conclusion: Among the hospitalized HF population, those with a history of cannabis use had a higher association with uncontrolled HTN, STEMI, NSTEMI, AKI, and stroke. They were also younger than their non-cannabis use counterparts. More research is needed to determine the significance of these findings.