Rates, Predictors and the Impact Cannabis Misuse on In-hospital Outcomes Among Patients Undergoing Percutaneous Coronary Intervention (From the National Inpatient Sample)

BACKGROUND: Whether cannabis use worsens outcomes in coronary heart disease is unknown and no previous study has evaluated outcomes for patients who undergo percutaneous coronary intervention (PCI) according to cannabis use.

METHODS: We analysed patients in the National Inpatient Sample between 2004 and 2014 who underwent PCI and evaluated rates, predictors and outcomes of patients according to cannabis misuse defined by cannabis abuse or dependence.

RESULTS: A total of 7,306,012 patients were included and 32,765 cannabis misusers (0.4%). Cannabis misusers were younger (49.5 vs 64.6 years, p<0.001) and were more likely to be male (82.7% vs 66.3%, p<0.001). There was also a greater proportion of patients that were of black ethnicity in the cannabis misuse group (27.7% vs 7.9%, p<0.001) and fewer elective admissions (7.8% vs 27.6%, p<0.001). There was no difference in in-hospital mortality (OR 1.06 95%CI 0.80-1.40, p=0.67), bleeding (OR 0.94 95%CI 0.77-1.15, p=0.55) and stroke/transient ischemic attack (OR 1.19 95%CI 0.98-1.45, p=0.084) compared to non-cannabis misusers. Cannabis misusers had significantly lower odds of in-hospital vascular complications (OR 0.73 95%CI 0.58-0.90, p=0.004).

CONCLUSIONS: Our results suggest that cannabis misusers are more likely to be male, of black ethnicity and from the lowest quartile of income, but there was no evidence that cannabis misuse is associated with worse peri-procedural outcomes following PCI when controlling for key proxies of health status.