Characteristics and outcomes of Marijuana users admitted with sudden cardiac arrest

Background: Marijuana or Cannabis is the most commonly used illicit drug in the United States. An estimated 2 million adults who reported marijuana use also have cardiovascular disease. Marijuana use has been associated with acute myocardial infarction, heart failure and arrhythmias. However, the implications of marijuana use on sudden cardiac arrest outcomes is unknown. Methods: Using the National Inpatient Sample of the years 2018 & 2019, patient characteristics and in-hospital outcomes were compared between marijuana users and non-marijuana users admitted with sudden cardiac arrest. Results: The median age of marijuana users was lower at 46.8years. They had significantly lower prevalence of congestive heart failure, coronary artery disease, valvular heart disease, pulmonary circulation disorders, atrial fibrillation, hypertension, and diabetes and a significantly higher prevalence of chronic liver disease, depression, alcohol use, tobacco use, amphetamine/psychostimulant use, opioid use, cocaine use, and sedative use. Multivariable logistic regression analysis showed significantly higher odds for ventricular fibrillation (OR: 1.24; 95% CI: 1.09- 1.41; p- 0.001) but lower odds for mortality (OR: 0.86; 95% CI: 0.78- 0.96; p-0.011), need for mechanical ventilation (OR: 0.76; 95% CI: 0.67- 0.86; p- 0.000), and tracheostomy (OR: 0.46; 95% CI: 0.34- 0.62; p- 0.000). Marijuana users were also more likely to be discharged home with self-care (25.25% vs 11.53%). Conclusion: Among patients admitted with sudden cardiac arrest, marijuana users were found to have significantly higher odds for ventricular fibrillation. They were found to have lower odds for in-hospital mortality, mechanical ventilation, and tracheostomy and were more likely to be discharged home with selfcare, but this is mostly because marijuana users who are admitted with sudden cardiac arrest were younger and had considerably fewer chronic medical conditions. Large prospective cohort studies are needed to ascertain the health risks associated with marijuana use.