Cannabis use did not worsen outcomes for 7.3 million heart procedure patients | Research

The takeaway

Among 7.3 million patients who underwent coronary stenting, cannabis users had no worse in-hospital outcomes and actually had lower rates of vascular complications.

Cardiologists, interventional cardiologists, and patients with heart disease who use cannabis.

7.3 million patients: no worse outcomes for cannabis users after coronary stenting

What the researchers found

In a national database of 7,306,012 PCI patients (2004-2014), 32,765 cannabis misusers had no significant differences in in-hospital mortality (OR 1.06), bleeding (OR 0.94), or stroke (OR 1.19) compared to non-users after adjustment. Cannabis users actually had significantly lower odds of vascular complications (OR 0.73, p=0.004).

Why it matters

Concerns about cannabis and cardiovascular risk are common, but few studies have examined outcomes after cardiac procedures. This massive dataset found no evidence of worse outcomes.

The numbers in context

7,306,012 total patients; 32,765 cannabis misusers (0.4%); cannabis users were younger (49.5 vs 64.6 years); no difference in mortality, bleeding, or stroke; lower vascular complications (OR 0.73).

How the study worked

Retrospective analysis of the National Inpatient Sample (2004-2014) comparing in-hospital outcomes after percutaneous coronary intervention between cannabis misusers and non-users, adjusting for health status proxies.

What this study cannot tell us

Observational database study; cannabis misuse identified by ICD codes (likely underreported); cannot distinguish type, frequency, or route of cannabis use; cannabis users were significantly younger, which may confound results despite adjustment.

How to read the evidence

Strong: massive national database with over 7 million patients and appropriate statistical adjustments, published in peer-reviewed clinical journal.

When this study was published

Published 2020.

The bigger picture

The finding that cannabis users had comparable or better procedural outcomes challenges assumptions about cannabis and acute cardiovascular risk. However, the younger age of cannabis users likely contributes to the favorable profile.

Questions still open

Would outcomes differ if cannabis users were age-matched to non-users? Does the route of cannabis consumption (smoking vs. edibles) affect cardiovascular procedural outcomes?

Common questions

Did cannabis use increase the risk of dying during heart procedures?

No. Among 7.3 million patients, cannabis users had no significant increase in in-hospital mortality after coronary stenting compared to non-users.

Were cannabis users different from non-users in this study?

Yes. Cannabis users were significantly younger (average 49.5 vs. 64.6 years), more likely male, and less likely to be admitted electively, which may partly explain the comparable outcomes.

Read the original research

Rates, predictors and the impact of cannabis misuse on in-hospital outcomes among patients undergoing percutaneous coronary intervention (from the National Inpatient Sample).

International journal of clinical practice, 74(5), e13477

View on PubMed ↗Publisher’s paper ↗

Citation

Kwok, Chun Shing; Alraies, M Chadi; Mohamed, Mohamed; Rashid, Muhammad; Shoaib, Ahmad; Nolan, James; Ratib, Karim; Khoo, Chee W; Kontopantelis, Evangelos; Mamas, Mamas A. (2020). Rates, predictors and the impact of cannabis misuse on in-hospital outcomes among patients undergoing percutaneous coronary intervention (from the National Inpatient Sample).. International journal of clinical practice, 74(5), e13477. https://doi.org/10.1111/ijcp.13477