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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
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
Bhavin Patel, Department of Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI 48341, United States
Sumanth Khadke, Lahey Hospital and Medical Center, Division of Cardiovascular Medicine, Department of Medicine, Burlington, MA 01805, United States
Kshitij Mahajan, Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, MI 48341, United States
Avleen Dhingra, Department of Medicine, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Rishika Trivedi, Department of Internal Medicine, DHR Health, Edinburg, TX 78539, United States
Samrath Singh Brar, Sakshi Dixit, Vaibhav Periwal, Department of Medicine, Government Medical College, Patiala 147001, Punjab, India
Shaylika Chauhan, Department of Internal Medicine, Geisinger Health System, Wikes-Barre, PA 18702, United States
Rupak Desai, Independent Researcher, Outcomes Research, Atlanta, GA 30079, United States
Author contributions: Patel B contributed to writing-original draft, writing-review, editing, visualization, and project administration; Khadke S contributed to writing-original draft, writing-review, and editing; Mahajan K contributed to writing-original draft, writing-review, editing, and data curation; Dhingra A contributed to writing-original draft, writing-review, editing, data curation, and visualization; Trivedi R, Brar SS, Dixit S, and Periwal V contributed to writing-review, editing, data curation, and visualization; Chauhan S contributed to writing-review, editing, project administration, and supervision; Desai R contributed to conceptualization, methodology, software, formal analysis, resources, data curation, writing-original draft, writing-review, editing, project administration, and supervision.
Institutional review board statement: Data is obtained from a publicly available data set, so patient identifiers are not used.
Informed consent statement: Informed consent statement was not needed because the study was carried out on a publicly available data set without patient identifiers.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author on request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Shaylika Chauhan, FACP, MD, Clinical Assistant Professor (Honorary), Department of Internal Medicine, Geisinger Health System, 1000 E Mountain Blvd, Wikes-Barre, PA 18702, United States.
drshaylikachauhan@gmail.com
Received: March 8, 2024
Revised: June 23, 2024
Accepted: July 4, 2024
Published online: September 20, 2024
Processing time: 174 Days and 1.9 Hours
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.
Core Tip: Among young hospitalized men, the cohort with Cannabis use disorder had a higher prevalence of anxiety and chronic obstructive pulmonary disease. Earlier studies have shown higher arrhythmia burden with cannabis use; however, this study population without concomitant tobacco use disorder was not associated with higher risk of atrial fibrillation when other sociodemographic and comorbid confounding variables were controlled. On subgroup analysis, blacks showed higher atrial fibrillation rates in the cannabis use disorder + arm.
