Association of cannabis use disorder with atrial fibrillation in young men without concomitant tobacco use: Insights from nationwide propensity matched analysis

Bhavin Patel; Sumanth Khadke; Kshitij Mahajan; Avleen Dhingra; Rishika Trivedi; Samrath Singh Brar; Sakshi Dixit; Vaibhav Periwal; Shaylika Chauhan; Rupak Desai

doi:10.5493/wjem.v14.i3.93742

Association of cannabis use disorder with atrial fibrillation in young men without concomitant tobacco use: Insights from nationwide propensity matched analysis

World J Exp Med. 2024 Sep 20;14(3):93742. doi: 10.5493/wjem.v14.i3.93742.

Authors

Affiliations

¹ Department of Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI 48341, United States.
² Lahey Hospital and Medical Center, Division of Cardiovascular Medicine, Department of Medicine, Burlington, MA 01805, United States.
³ Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, MI 48341, United States.
⁴ Department of Medicine, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India.
⁵ Department of Internal Medicine, DHR Health, Edinburg, TX 78539, United States.
⁶ Department of Medicine, Government Medical College, Patiala 147001, Punjab, India.
⁷ Department of Internal Medicine, Geisinger Health System, Wikes-Barre, PA 18702, United States. drshaylikachauhan@gmail.com.
⁸ Independent Researcher, Outcomes Research, Atlanta, GA 30079, United States.

Abstract

Background: Recent data are inconclusive regarding the risk of arrhythmias among young cannabis users. Furthermore, many young adults use both cannabis and tobacco, which could add a residual confounding effect on outcomes. So, we studied young men who have cannabis use disorder (CUD) excluding tobacco use disorder (TUD) to understand their independent association with atrial fibrillation (AF) and related outcomes.

Aim: To study the association of CUD with AF and related outcomes.

Methods: We used weighted discharge records from National Inpatient Sample (2019) to assess the baseline characteristics and mortality rates for AF-related hospitalizations in young (18-44 years) men in 1:1 propensity-matched CUD + vs CUD- cohorts without TUD.

Results: Propensity matched CUD + and CUD- cohorts consisted of 108495 young men in each arm. Our analysis showed an increased incidence of AF in black population with CUD. In addition, the CUD + cohort had lower rates of hyperlipidemia (6.4% vs 6.9%), hypertension (5.3% vs 6.3%), obesity (9.1% vs 10.9%), alcohol abuse (15.5% vs 16.9%), but had higher rates of anxiety (24.3% vs 18.4%) and chronic obstructive pulmonary disease (COPD) (9.8% vs 9.4%) compared to CUD-cohort. After adjustment with covariates including other substance abuse, a non-significant association was found between CUD + cohort and AF related hospitalizations (odd ratio: 1.27, 95% confidence interval: 0.91-1.78, P = 0.15).

Conclusion: Among hospitalized young men, the CUD + cohort had a higher prevalence of anxiety and COPD, and slightly higher proportion of black patients. Although there were higher odds of AF hospitalizations in CUD + cohort without TUD, the association was statistically non-significant. The subgroup analysis showed higher rates of AF in black patients. Large-scale prospective studies are required to evaluate long-term effects of CUD on AF risk and prognosis without TUD and concomitant substance abuse.

Keywords: Atrial fibrillation; Cannabis; Marijuana; Original research; Smoking; Tobacco use disorder.