Abstract 4147132: Impact of Cannabis Use Disorder on Major Adverse Cardiovascular Events in Hospitalized Young Female Patients with Established Cardiovascular Disease Risk: A Nationwide Analysis from 2016-2020

Introduction: Cannabis use disorder (CUD) has been associated with major adverse cardiac events (MACE). Additionally, preexisting cardiovascular disease (CVD) poses a major threat to young female patients, but the impact of CUD on MACE remains largely unexplored. Methodology: A retrospective cohort study was undertaken, utilizing data from the National Inpatient Sample dataset spanning from 2016 to 2020. Female patients aged 18-45 years with CVD risk factors (Hypertension, Diabetes Mellitus, Hyperlipidemia, Obesity) were divided into two groups: those with cannabis use disorder (CUD+) and those without (CUD-). Demographic characteristics, comorbidities, and MACE (myocardial infarction (MI), atrial fibrillation (AF), venous thromboembolism (VTE), cardiac arrest (CA), stroke, and all-cause mortality) were explored. Multivariable regression analysis was performed for all the outcomes reported under MACE. Results: Of the 7,245,508 hospitalized young females with CVD risk factors, 3.5% had CUD. CUD+ group was younger (31 vs. 33 years), had more Black patients (37.2 vs. 25.1%) and were more likely to be using Medicaid (59.2 vs. 42.4%). Comorbidities such as complicated diabetes (19.6 vs 13%), smoking (29.4 vs 15.7%), chronic pulmonary disease (22.4 vs 15.2%), drug abuse (64.1 vs 3.7%), alcohol use (10.1 vs 1.8%), and cocaine use (9.2 vs 0.7%) had higher prevalence in CUD+ group (p<0.001). Higher prevalence of MI, CA, and stroke in the CUD+ group, and secondary outcomes showed lower cost of hospitalization, similar length of stay, and a higher number of patient transfers to intermediate care facilities. Multivariable analysis showed that CUD was associated with higher odds of stroke (aOR 1.20) and lower odds for VTE, CA and AF. Conclusion: Young female patients with CUD and established CVD risk factors present a unique clinical profile. While CUD seems to lower the odds of certain cardiovascular events, it significantly heightens the risk of stroke. This further increases the necessity for interventions and healthcare policies aimed at this specific population.