Cardiovascular Risks Associated With Cannabis Use Among ED Patients

Objectives Cannabis is one of the most widely used psychoactive substances, and many adults meet the criteria for Cannabis Use Disorder (CUD). Prior research on its association with cardiovascular disease (CVD) has yielded mixed results. This study evaluates the relationship between CUD and CVD among ED patients. Methods This retrospective, propensity-matched analysis examined records from 67 US healthcare organizations (HCOs) in the TriNetX database from 2005 to 2022. Adult ED patients with CUD documented within five years before or one month after an ED visit were compared with those without CUD. A secondary analysis compared patients with CUD to those with alcohol-related disorders (ARD). Outcomes included all-cause mortality, stroke, and myocardial infarction (MI) within three years of the ED visit. Matching controlled for demographics and comorbidities. Results A total of 1,748,263 ED patients were identified. After propensity matching, 598,114 adult patients remained, with 299,057 in each of the CUD and no-CUD groups. Patients with CUD experienced higher rates of mortality (RR 1.69, 95% CI 1.64-1.75) and MI (RR 1.07, 95% CI 1.02-1.12) within three years compared with those without CUD, with no significant difference in stroke (RR 0.96, 95% CI 0.90-1.02). In the secondary analysis, patients with CUD showed lower mortality but higher rates of stroke and MI than those with ARD. Conclusion Cannabis use was associated with increased risks of mortality and MI within three years of an ED visit. These findings add to the existing literature on the cardiovascular implications of cannabis use and may help inform health policy and clinical decision-making.