Abstract 14752: Among Patients With Heart Failure, Cannabis Use is Associated With Reduced Occurrence of Atrial Fibrillation and In-hospital Mortality; Evidence From the Nationwide Survey 2007-2014
Background: One of the intrinsic compensatory mechanisms in heart failure is sympathetic system activation. Hyperadrenergic states are known to increase the risk of atrial fibrillation. Cannabis has been shown to cause an hyperadrenergic state. The effect of cannabis on the occurrence and outcome of atrial fibrillation in patients with heart failure is largely unknown. Therefore, we sought to investigate this association.
Method: We used data from the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) of all patients older than 18 years admitted with the primary diagnosis of heart failure between 2007 - 2014. The main outcome variable was the diagnosis of atrial fibrillation, and the main exposure variable was cannabis use. We performed 1:5 matched - cohort to create 2 case-control groups, the first group was for cannabis dependent users (DU) (cases) vs non-cannabis users (NCU) (controls) and the second group was for cannabis non-dependent users (NDU) (cases) vs NCU (controls). We then used the survey logistics procedure to estimate the odds of atrial fibrillation diagnosis among cannabis users, adjusting for comorbidities.
Results: Among 6,065,000 heart failure hospitalization, there were 1,213 (0.02%) DU and 23,737 (0.40%) NDU. When compared to NCU, we observed significantly reduced odds of atrial fibrillation among cannabis users (DU Odd Ratio (OR): 0.69, Confidence Interval (CI): [0.53 - 0.89] vs NDU OR: 0.82. CI: [0.77- 0.87]) after adjusting for comorbidities. We also demonstrated reduced odds of in-hospital mortality (DU OR: 0.42, CI: [0.22 - 0.88] vs NDU OR: 0.54, CI: [0.47- 0.63]) and reduced length of stay (DU OR: 0.04, CI: [-0.15 - 0.06]) vs NDU OR: 0.20, CI: [-0.23 - ( -0.17)] among cannabis users admitted for heart failure compared to NCU.
Conclusions: Our study showed that cannabis use lowered the odds of atrial fibrillation in patients with heart failure. There was also reduced in-hospital mortality among patients admitted for the primary diagnosis of heart failure in DU and NDU which was not explained by comorbid conditions and demographic data. This study provides important opportunity to explore the preventive mechanism of cannabis on atrial fibrillation and its therapeutic potential in heart failure patients.
Author Disclosures: O. Adegbala: None. A. Akinjero: None. A. Adejumo: None. S. Alliu: None. E. Akintoye: None. E. Edo-Osagie: None. T. Akinyemiju: None.
- © 2017 by American Heart Association, Inc.