Abstract 15470: Increased Risk of Major Adverse Cardiac and Cerebrovascular Events in Elderly Non-Smokers With Cannabis Use Disorder: A Population-Based Analysis

Background: Tobacco smoking confounds CVD risk studies. No large-scale investigation has been performed yet to examine cannabis use disorder (CUD) in elderly non-smokers with established CVD risk and major adverse cardiac and cerebrovascular events (MACCE).

Methods: The National Inpatient Sample (2019) was queried using relevant ICD-10 codes to identify elderly (>65 years) admissions with established CVD risk without known tobacco use disorder and stratified into CUD and non-CUD cohorts. Logistic regression evaluated MACCE odds as primary outcomes and secondary outcomes as predictors of MACCE incidents in CUD users. P< 0.05 was considered significant.

Results: Of 28,535 elderly cannabis users with CVD risk and no tobacco use disorder, 13.9% reported MACCE episodes. CUD patients were more likely to be male, black, and non-electively admitted from urban teaching and Western region hospitals. AIDS, alcohol abuse, depression, uncomplicated hypertension, and drug abuse were greater in the CUD cohort, while the non-CUD group had more complicated hypertension, diabetes with and without chronic comorbidities, hyperlipidemia, obesity, thyroid issues, previous strokes, VTE, cancer. The CUD cohort reported higher MACCE (OR 1.20; 95% CI 1.11-1.29). ACM (3.3% vs. 1.7%), dysrhythmia (34.9% vs. 24.9), acute myocardial infarction (7.6% vs. 6.0%, p 0.001), transfer to other facilities (28.9% vs. 19.0%), and home health care (22.4%) compared to non-CUD cohort (p 0.001). Chronic lung disease, renal disease, hypertension, and hyperlipidemia were predictors of MACCE episodes in CUD users.

Conclusion: Even after controlling for smoking, elderly cannabis users having CVD risk had 20% more MACCE events encountered than non-users. Cannabis use in older non-smokers deserves investigation into CVD. risks