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Higher odds and rising trends in arrhythmia among young cannabis users with comorbid depression

      Highlights

      • Of 2011,598 young cannabis users (59.6% male), 190,146 (9.5%) had comorbid depression.
      • Cannabis users with depression were more likely older, white and female.
      • Of 190,146 cannabis users with depression, 6.9% experienced arrhythmias (AF most common).
      • More rapidly rising trends in arrhythmia were seen among depressed cannabis users (4.9% in 2007 to 8.5% in 2014).
      • Young depressed cannabis users had ~40% higher odds of arrhythmia compared to non-depressed.

      Abstract

      Background

      Cannabis (marijuana) use and depression are known to be strongly interconnected. However, amid alarming rates of mental health problems in the United States young population, the risk of arrhythmia among young cannabis users with comorbid depression has never been studied.

      Methods

      In-hospital encounters of arrhythmia were identified among young cannabis users (18–39 years) with or without depression using the National Inpatient Sample (2007–2014) databases and apposite ICD-9 codes. Baseline characteristics and trends in prevalence of arrhythmia were evaluated among inpatient young cannabis users with or without depression. A multivariable regression was performed after adjusting for baseline demographics, comorbidities and parallel history of substance abuse.

      Results

      Of 2,011,598 young cannabis users (59.6% male) admitted from 2007–2014, 190,146 (9.5%) of patients had comorbid depression, of which 6.9% of patients experienced arrhythmias with atrial fibrillation being most common. Cannabis users with depression were more likely older, white, females and frequently hospitalized in Midwest and rural hospitals. We observed a steadily rising trend in prevalence of arrhythmia in both groups, but a more rapid rise in cannabis users with depression (4.9% in 2007 to 8.5% in 2014 vs. 3.7% in 2007 to 5.7% in 2014). Correspondingly, young depressed cannabis users had higher odds of arrhythmia compared to non-depressed even after controlling for demographics and comorbidities (OR: 1.41, 95% CI: 1.38–1.44, p<0.001).

      Conclusion

      Rampant recreational use of marijuana may increase the risk of arrhythmia by 40% in young cannabis users with depression as compared to non-depressed.

      Keywords

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      References

        • Hasin D.S.
        • Saha T.D.
        • Kerridge B.T.
        • Goldstein R.B.
        • Chou S.P.
        • Zhang H.
        • et al.
        Prevalence of Marijuana use disorders in the United States between 2001-2002 and 2012-2013.
        JAMA Psychiatry. 2015; 72: 1235-1242
        • Gobbi G.
        • Atkin T.
        • Zytynski T.
        • Wang S.
        • Askari S.
        • Boruff J.
        • et al.
        Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis.
        JAMA Psychiatry. 2019; 76: 426-434
        • Lev-Ran S.
        • Le Foll B.
        • McKenzie K.
        • George T.P.
        • Rehm J.
        Cannabis use and cannabis use disorders among individuals with mental illness.
        Compr Psychiatry. 2013; 54: 589-598
        • McGuinness T.M.
        Update on marijuana.
        J Psychosoc Nurs Ment Health Serv. 2009; 47: 19-22
        • Nussbaum A.M.
        • Thurstone C.
        • McGarry L.
        • Walker B.
        • Sabel A.L.
        Use and diversion of medical marijuana among adults admitted to inpatient psychiatry.
        Am J Drug Alcohol Abuse. 2015; 41: 166-172
        • Reece A.S.
        Chronic toxicology of cannabis.
        Clin Toxicol (Phila). 2009; 47: 517-524
        • Huffman J.C.
        • Celano C.M.
        • Januzzi J.L.
        The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes.
        Neuropsychiatr Dis Treat. 2010; 6: 123-136
        • Desai R.
        • Patel U.
        • Deshmukh A.
        • Sachdeva R.
        • Kumar G.
        Burden of arrhythmia in recreational marijuana users.
        Int J Cardiol. 2018; 264: 91-92
        • Desai R.
        • Patel U.
        • Sharma S.
        • Amin P.
        • Bhuva R.
        • Patel M.S.
        • et al.
        Recreational Marijuana Use and Acute Myocardial Infarction: insights from Nationwide Inpatient Sample in the United States.
        Cureus. 2017; 9: e1816
        • Manolis T.A.
        • Manolis A.A.
        • Manolis A.S.
        Cannabis associated “High” cardiovascular morbidity and mortality: marijuana smoke like tobacco smoke? A Deja Vu/Deja Vecu Story?.
        Mini Rev Med Chem. 2019; 19: 870-879
        • Parekh T.
        • Pemmasani S.
        • Desai R.
        Marijuana use among young adults (18-44 years of age) and risk of stroke: a behavioral risk factor surveillance system survey analysis.
        Stroke. 2020; 51: 308-310
        • Desai R.
        • Shamim S.
        • Patel K.
        • Sadolikar A.
        • Kaur V.P.
        • Bhivandkar S.
        • et al.
        primary causes of hospitalizations and procedures, predictors of in-hospital mortality, and trends in cardiovascular and cerebrovascular events among recreational marijuana users: a five-year nationwide inpatient assessment in the United States.
        Cureus. 2018; 10: e3195
        • HCUP Databases
        Healthcare cost and utilization project (HCUP).
        Agency for Healthcare Research and Quality, Rockville, MDDecember 2019
        www.hcup-us.ahrq.gov/nisoverview.jsp
        Date accessed: January 6, 2020
        • Substance Abuse and Mental Health Services Administration
        Key substance use and mental health indicators in the united states: results from the 2016 national survey on drug use and health (HHS publication no. sma 17-5044, nsduh series H-52).
        Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD2017 (Retrieved from)
        https://www.samhsa.gov/data/
        Date accessed: January 4, 2020
        • Brenner S.L.
        • Beauchaine T.P.
        Pre-ejection period reactivity and psychiatric comorbidity prospectively predict substance use initiation among middle-schoolers: a pilot study.
        Psychophysiology. 2011; 48: 1588-1596
        • Daccarett M.
        • Freih M.
        • Machado C.
        Acute cannabis intoxication mimicking brugada-like ST segment abnormalities.
        Int J Cardiol. 2007; 119: 235-236
        • Desai R.
        • Fong H.K.
        • Shah K.
        • Kaur V.P.
        • Savani S.
        • Gangani K.
        • et al.
        Rising trends in hospitalizations for cardiovascular events among young cannabis users (18-39 years) without other substance abuse.
        Medicina (Kaunas). 2019; 55