Prevalence, trends and in-hospital outcomes of takotsubo syndrome among United States cannabis users
Takotsubo syndrome, Takotsubo cardiomyopathy, Stress-induced cardiomyopathy, Cannabis, Marijuana, Trends
Cardiology | Cardiovascular Diseases
BackgroundRecent reports suggest a link between increased cannabis (marijuana) use and stress-cardiomyopathy (Takotsubo Syndrome, TTS) and related complications. Amidst recent trends in cannabis legalization and a paucity of data, it remains essential to evaluate the prevalence, trends and outcomes of TTS in cannabis users on a large-scale.
MethodWe studied prevalence and trends in TTS among adult cannabis users vs. non-users using the National Inpatient Sample (2007–2014). Baseline characteristics, comorbidities, and in-hospital outcomes of TTS were compared between cannabis users vs. non-users. Weighted logistic regression was performed adjusting for confounders to estimate the inpatient outcomes of TTS with vs. without cannabis use.
ResultsThe overall prevalence of TTS in cannabis users (47/100,000) was lower as compared to non-users (62/100,000). Rising trends in TTS among cannabis users (<11 to 82, ~8-fold) were more pronounced as compared to non-users (19 to 108, ~6 fold) per 100,000 hospitalizations from 2007 to 2014 (p trend < 0.001). Of all inpatient encounters for TTS ( n = 156,506), 1565 (0.1%) reported cannabis use. Polysubstance use including alcohol (4.1% vs. 24.4%), cocaine (0.4% vs. 8.5%), amphetamine (0.2% vs. 8.0%), and smoking (31.2% vs. 64.8%) was significantly higher in TTS-cannabis cohort. Although cardiovascular comorbidities were lower in TTS-cannabis cohort, the adjusted odds of all-cause mortality (aOR1.50, p < .05) were 50% higher in cannabis users compared to non-users without statistically significant difference in cardiac complications.
ConclusionsCannabis users showed lower prevalence but a more pronounced rising trend of TTS and subsequent risk of in-hospital mortality compared to non-users.
Publisher or Conference
International Journal of Cardiology
Desai R, Desai A, Fong HK, et al. Prevalence, trends and in-hospital outcomes of takotsubo syndrome among United States cannabis users [published online ahead of print, 2020 Jun 5]. Int J Cardiol. 2020;S0167-5273(20)30466-6. doi:10.1016/j.ijcard.2020.05.088