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Published on: August 18, 2020
Cannabis Use Disorder Is Associated With Increased Risk of Acute Myocardial Infarction in Adults With Metabolic
Basile Njei1,2,3,4,5, Sarpong Boateng6, Ifeoma Kwentoh7
1Medicine, Yale University School of Medicine, New Haven, USA.
Insights
Cannabis use disorder (CUD) in patients with metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis increases the risk of acute myocardial infarction (MI). However, CUD did not correlate with higher in-hospital mortality or major adverse cardiovascular events in this population.
Area of Science:
- Cardiology
- Hepatology
- Addiction Medicine
Background:
- Cannabis use disorder (CUD) and metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis are independently linked to adverse cardiometabolic profiles.
- Co-occurrence of CUD and MASH cirrhosis raises concerns for potential cardiovascular complications.
Purpose of the Study:
- To evaluate the association between CUD and acute myocardial infarction (MI) in hospitalized adults with MASH cirrhosis.
Main Methods:
- Retrospective cross-sectional analysis of the National Inpatient Sample (2016-2020).
- Inclusion of adult patients hospitalized with MASH cirrhosis.
- Identification of CUD using ICD-10-CM codes.
- Multivariable logistic and Poisson regression models to assess associations with acute MI, mortality, MACE, hepatic decompensation, length of stay, and costs.
Main Results:
- Among 57,754 MASH cirrhosis hospitalizations, 539 involved CUD.
- CUD was significantly associated with a higher likelihood of acute MI (aOR 2.18; 95% CI 1.30-3.63).
- No significant associations found between CUD and in-hospital mortality or major adverse cardiovascular events (MACE).
- CUD associated with lower odds of hepatic decompensation and lower hospitalization costs.
Conclusions:
- Hospitalized adults with MASH cirrhosis and CUD face an elevated risk of acute MI.
- CUD was not associated with increased in-hospital mortality or overall MACE in this cohort.
- Highlights the need for cardiovascular risk assessment and CUD screening in MASH cirrhosis patients.
- Findings represent associations, not causality, due to observational study design.
Introduction:
Cannabis use disorder (CUD) is encountered among hospitalized adults with metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis. Both conditions are independently associated with adverse cardiometabolic profiles, raising concern for potential cardiovascular complications when they coexist. This study evaluated the association between CUD and acute myocardial infarction (MI) among hospitalized adults with MASH cirrhosis.
Methods:
We performed a retrospective cross-sectional analysis of the National Inpatient Sample from 2016 to 2020, including adults aged ≥18 years hospitalized with MASH cirrhosis. CUD was identified using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Multivariable logistic and Poisson regression models were used to examine associations between CUD and acute MI, in-hospital mortality, major adverse cardiovascular events, hepatic decompensation, length of stay, and hospitalization costs, adjusting for demographics, comorbidities, and hospital characteristics.
Results:
Among 57,754 hospitalizations for MASH cirrhosis, 539 involved patients with CUD. CUD was associated with a significantly higher likelihood of acute MI (adjusted odds ratio 2.18; 95% CI 1.30-3.63). No significant associations were observed between CUD and in-hospital mortality or overall major adverse cardiovascular events. CUD was associated with lower odds of hepatic decompensation. Hospitalizations involving CUD were associated with lower adjusted costs, while length of stay did not differ significantly between groups.
Conclusion:
Among hospitalized adults with MASH cirrhosis, CUD was associated with a higher risk of acute MI but not with increased in-hospital mortality or overall major adverse cardiovascular events. These findings underscore the importance of cardiovascular risk assessment and CUD identification in this population. As this was an observational cross-sectional study, the findings represent associations and do not establish causality.
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