Abstract 4145671: Characteristics and Association of Cannabis Use on Cardiovascular Outcomes in patients hospitalized with Atrial Fibrillation: An NRD Propensity Matched Analysis

Background: Cannabis use is rapidly rising with its legalization across multiple regions of the USA. Recent literature has identified that Atrial Fibrillation is the most common arrhythmia identified in cannabis users. Further research is needed to elucidate the impact of cannabis use in patients with Atrial Fibrillation. Aim: We aim to study the difference in characteristics and outcomes in patients with Atrial Fibrillation based on cannabis use through the National Readmission Database(2016-2020). Methods: NRD database was used to identify patients with Atrial Fibrillation using ICD-10 codes. Patients were stratified into two groups based on history of cannabis dependence. Information was collected on patient demographics, comorbidities, and outcomes. Propensity score matching was performed to compare outcomes among AFib patients based on cannabis use. Results: 12,394,481 patients with AFib were included in the analysis. Of these cannabis use was identified in 104,837 (0.84%) patients. The patients in the cannabis group were younger (60.2+- 0.03 yrs vs 75.16 +- 0.06 yrs), and had a higher prevalence of males (73.8% vs 52.9%) in comparison with the non cannabis group. Cannabis group had a higher rate of Obesity (20.98% vs 19.83), prior MI (12.04% vs 10.69), pulmonary disease (30.17% vs 26.61%) and liver disease (4.17% vs 2.33%) in comparison with the non-cannabis group. In the propensity matched analysis, cannabis group had a higher rate of myocardial infarction (5.59% vs 5.32%; p<0.001) and Acute Stroke (1.66% vs 1.64%, p<0.001). The cannabis group had a ra lower rate of in-hospital death (3.77% vs 4.74%, p<0.001), acute kidney injury (25.24% vs 25.93; p<0.001), heart failure (44.09% vs 46.34%; p<0.001), sudden cardiac arrest (0.88% vs 0.75%;p<0.001), mechanical circulatory device use(3.12% vs 3.5%;p<0.001), major adverse cardiovascular events (11.6% vs 12.13%;p<0.001) and net adverse events(59.55% vs 61.17%, p<0.001) Discussion: Group with Afib and Cannabis use displayed a lower mean age and lower prevalence of females in comparison with the non-cannabis group. Furthermore, unmatched outcome analysis showed a higher rate of AKI, MI, sudden cardiac death and MACE among cannabis users in comparison with non-cannabis users. In comparison, propensity score matched outcomes displayed higher rates of acute stroke and myocardial infarction. Understanding the relationship between cannabis use and atrial fibrillation is crucial for improving outcomes.