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Although marijuana use is considered a trigger for acute coronary syndrome (ACS), the studies assessing marijuana use and ACS have shown inconsistent results. The CARDIA study concluded that marijuana use was associated with lifetime risk of atherosclerosis only among cigarette smokers. Due to legalization of recreational marijuana in several states, its use has been expected to rise. In that background, we aimed to perform a database review to assess the relationship between marijuana use with the risk of coronary artery disease (CAD), ACS and inpatient mortality.
We queried the National Inpatient Sample (NIS) using ICD-9 code for marijuana use (305.2) for 2013 and 2014. After identifying marijuana users and non-users, we calculated the odds ratio (OR) for CAD, ACS and inpatient mortality. Analyses were performed after adjustment for DM, HTN, hyperlipidemia, revascularization history, obesity and cigarette smoking.
Retrospective review of NIS for two consecutive years (2013 and 2014) identified a total of 729,319 marijuana users and 50, 859, 638 non-users. Marijuana users were younger compared to non-users (39.06±13.7 vs. 62.1±18 years of age) and less likely to have associated risk factors of CAD (DM, HTN, obesity and smoking). Marijuana users compared to non-users had lower odds of developing CAD in unadjusted [odds ratio (OR): 0.29; 95% confidence interval (CI): 0.28-0.29; P<0.001] and adjusted (0.50; CI 0.49-0.51; P<0.001) analyses. Similarly, for ACS, unadjusted and adjusted ORs were 0.49 [CI 0.48-0.51, P<0.001] and 0.65 [CI 0.63-0.67; P<0.001] respectively. Unadjusted OR of inpatient mortality in hospitalized marijuana users was 0.27 [CI 0.25-0.28; P<0.001] and adjusted OR of inpatient mortality in hospitalized marijuana users 0.64 [CI 0.60-0.68; P<0.001].
The current analysis of large NIS showed that marijuana users tend to be younger with lower incidence of CAD risk factors. Adjusted and unadjusted analyses show lower odds of CAD, ACS and inpatient mortality among marijuana users vs. non-users. Future research should further explore this relationship.
Poster Hall, Hall F
Saturday, March 16, 2019, 3:45 p.m.-4:30 p.m.
Session Title: Acute and Stable Ischemic Heart Disease: Clinical 2
Abstract Category: 02. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1177-387
- 2019 American College of Cardiology Foundation