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Desai R, Brereton B, Patta HVC, Bansal P, Jain A, Vyas A. Prevalence and impact of cannabis use disorder on acute ischemic stroke and subsequent mortality in elderly peripheral vascular disease patients: A population-based analysis in the USA (2016 - 2019). Curr Probl Cardiol 2024; 49:102162. [PMID: 37871709 DOI: 10.1016/j.cpcardiol.2023.102162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND Given current evidence linking peripheral atherosclerotic disease, also known as cannabis arteritis, and acute ischemic stroke (AIS) in individuals with cannabis use disorder (CUD), we investigated the frequency and implications of CUD in relation to AIS risk and outcomes among elderly patients with peripheral vascular disease (PVD). METHODS The National Inpatient Sample (2016-2019) was used to compare geriatric patients with PVD and cannabis use disorder CUD. CUD was correlated with AIS admissions. Adjusted multivariable regression models assessed in-hospital mortality rates. RESULTS Of 5,115,824 geriatric admissions with PVD, 50.6 % were male and 77.5 % were white. 21,405 admissions had cardiovascular and CUD co-occurrence. 19.7 % of CUD patients had diabetes mellitus (DM), compared to 33.7 % of non-CUD patients. Smoking and HTN rates were comparable between groups. Patients with CUD used more recreational drugs concurrently than those without CUD. AIS prevalence was 5.2 % in CUD patients and 4.0 % in controls (p < 0.001). In the geriatric population with PVD, the presence of CUD was found to be associated with increased odds of hospitalizations due to AIS, with an adjusted odds ratio (aOR) of 1.34 (95 % confidence interval [CI] 1.18-1.52, p < 0.001). All-cause in-hospital mortality was not statistically significant, with an aOR of 0.71 (95 %CI 0.36-1.37, p = 0.302). In our study, older patients with PVD and hypertension (aOR 1.73) had a greater risk of AIS. Intriguingly, when we analyzed AIS predictors in elderly PVD patients with concurrent tobacco use disorder, we identified a counterintuitive protective effect (aOR 0.58, 95 % CI 0.42-0.79, p < 0.001). CONCLUSIONS Our findings indicate that among geriatric patients with PVD and concurrent CUD, there is a notable 34 % risk of AIS. Importantly, this risk persists despite controlling for other CVD risk factors and substance use. Further investigations are warranted to elucidate and validate the intriguing phenomenon known as the smoker's paradox.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA
| | - Brian Brereton
- Department of Medicine, Jersey General Hospital, St. Helier, Jersey
| | | | - Prerna Bansal
- Department of Medicine, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Akhil Jain
- Division of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ankit Vyas
- Division of Vascular Medicine, Ochsner Clinic Foundation, New Orleans, LA, USA.
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Desai R, Jain A, Patel BA, Sadolikar A, Alukal T. Young diabetics remain at higher risk of acute myocardial infarction with cannabis use disorder. Eur J Intern Med 2023; 108:125-127. [PMID: 36202716 DOI: 10.1016/j.ejim.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/25/2022] [Accepted: 09/28/2022] [Indexed: 02/07/2023]
Affiliation(s)
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA.
| | - Bhavin A Patel
- Department of Internal Medicine, Saint Joseph Mercy Oakland Hospital, Pontiac, MI, USA
| | - Ashish Sadolikar
- Department of Internal Medicine, Indiana University Health Southern Indiana Physicians, Bloomington, IN, USA
| | - Thomas Alukal
- Department of Internal Medicine, VCU Health, South Hill, VA, USA
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Patel HP, Thakkar S, Mehta N, Faisaluddin M, Munshi RF, Kumar A, Khan SU, Parikh R, DeSimone CV, Sharma G, Deshmukh A, Nasir K, Ganatra S, Dani SS. Racial disparities in ventricular tachycardia in young adults: analysis of national trends. J Interv Card Electrophysiol 2023; 66:193-202. [PMID: 35947319 DOI: 10.1007/s10840-022-01335-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 08/02/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND In the last two decades, risk factors, prevalence, and mortality due to coronary artery disease in young adults are on the rise. We sought to assess the prevalence, trends, and economic burden of ventricular tachycardia (VT) hospitalizations in young adults (< 45 years), further stratified by race and gender. METHODS The Nationwide Inpatient Sample was explored for hospitalizations with VT in patients (< 45 years) between 2005 and 2018 and divided among 3 groups of the quadrennial period using validated International Classification of Diseases (ICD) 9th and 10th revision Clinical Modification (CM) codes. The Pearson chi-square test and Wilcoxon rank-sum were used for categorical and continuous variables, respectively. We assessed the temporal trends of mortality in VT hospitalizations and trends of VT hospitalization stratified by age, sex, and race by using Joinpoint regression analysis. The primary outcome was in-hospital mortality trends. Secondary outcomes were trends of hospital stay in days, cost of care in US dollars, cardiac arrest, and discharge disposition. RESULTS Out of 5,156,326 patients admitted with VT between 2005 and 2018, 309,636 were young adults. Among them, 102,433 were admitted between 2005 and 2009 (mean age 36.1 ± 6.99; 61% male, 58.5% White), 109,591 between 2010 and 2014 (mean age 35.5 ± 7.16; 59% male, 54.2% White), and 97,495 between 2015 and 2018 (mean age 35.4 ± 7.00; 60% male, 52.3% White) (p < 0.07). In the young adults with VT, all-cause mortality was 7.37% from 2005 to 2009, 7.85% from 2010 to 2014 (6.5% relative increase from 2005 to 2009), and 8.98% from 2015 to 2018 (relative increase of 14.4% from 2010 to 2014) (p < 0.0001). Similarly, risk of cardiac arrest was on the rise (6.15% from 2005 to 2009 to 7.77% in 2010-2014 and 9.97% in 2015-2018). Inflation-adjusted cost increased over the years [$12,177 in 2005-2009; $13,249 in 2010-2014; $15,807 in 2015-2018; p < 0.0001)]. CONCLUSIONS VT hospitalizations and related all-cause mortality, and healthcare utilization costs in young adults are on the rise in the study period. Hospitalization burden related to VT and poor outcomes were more notable for Black adults. Further studies are required for targeted screening and preventative measures in young adults.
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Affiliation(s)
- Harsh P Patel
- Department of Cardiology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Samarthkumar Thakkar
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Nishaki Mehta
- Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Beaumont Hospital Royal Oak, Royal Oak, MI, USA
| | | | - Rezwan F Munshi
- Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA
| | - Ashish Kumar
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA
| | - Safi U Khan
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Rohan Parikh
- Department of Cardiology, Lahey Hospital & Medical Center, 41 Burlington Mall Road, Burlington, MA, 01805, USA
| | | | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Abhishek Deshmukh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Khurram Nasir
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
| | - Sarju Ganatra
- Department of Cardiology, Lahey Hospital & Medical Center, 41 Burlington Mall Road, Burlington, MA, 01805, USA
| | - Sourbha S Dani
- Department of Cardiology, Lahey Hospital & Medical Center, 41 Burlington Mall Road, Burlington, MA, 01805, USA.
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Desai R, Jain A, Sultan W, Gandhi Z, Raju AR, Varughese VJ, Jnaneswaran G, Agarwal C, Rizvi B, Mansuri Z, Gupta P, Kumar G, Sachdeva R. Hypertensive Crisis-Related Hospitalizations and Subsequent Major Adverse Cardiac Events in Young Adults with Cannabis Use Disorder: A Nationwide Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101465. [PMID: 36295625 PMCID: PMC9609556 DOI: 10.3390/medicina58101465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Background and Objectives: With the growing recreational cannabis use and recent reports linking it to hypertension, we sought to determine the risk of hypertensive crisis (HC) hospitalizations and major adverse cardiac and cerebrovascular events (MACCE) in young adults with cannabis use disorder (CUD+). Material and Methods: Young adult hospitalizations (18−44 years) with HC and CUD+ were identified from National Inpatient Sample (October 2015−December 2017). Primary outcomes included prevalence and odds of HC with CUD. Co-primary (in-hospital MACCE) and secondary outcomes (resource utilization) were compared between propensity-matched CUD+ and CUD- cohorts in HC admissions. Results: Young CUD+ had higher prevalence of HC (0.7%, n = 4675) than CUD- (0.5%, n = 92,755), with higher odds when adjusted for patient/hospital-characteristics, comorbidities, alcohol and tobacco use disorder, cocaine and stimulant use (aOR 1.15, 95%CI:1.06−1.24, p = 0.001). CUD+ had significantly increased adjusted odds of HC (for sociodemographic, hospital-level characteristics, comorbidities, tobacco use disorder, and alcohol abuse) (aOR 1.17, 95%CI:1.01−1.36, p = 0.034) among young with benign hypertension, but failed to reach significance when additionally adjusted for cocaine/stimulant use (aOR 1.12, p = 0.154). Propensity-matched CUD+ cohort (n = 4440, median age 36 years, 64.2% male, 64.4% blacks) showed higher rates of substance abuse, depression, psychosis, previous myocardial infarction, valvular heart disease, chronic pulmonary disease, pulmonary circulation disease, and liver disease. CUD+ had higher odds of all-cause mortality (aOR 5.74, 95%CI:2.55−12.91, p < 0.001), arrhythmia (aOR 1.73, 95%CI:1.38−2.17, p < 0.001) and stroke (aOR 1.46, 95%CI:1.02−2.10, p = 0.040). CUD+ cohort had fewer routine discharges with comparable in-hospital stay and cost. Conclusions: Young CUD+ cohort had higher rate and odds of HC admissions than CUD-, with prevalent disparities and higher subsequent risk of all-cause mortality, arrhythmia and stroke.
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Affiliation(s)
- Rupak Desai
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Correspondence: or
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA 19153, USA
| | - Waleed Sultan
- Department of Family Medicine, Conemaugh Memorial Medical Center, Johnstown, PA 15905, USA
| | - Zainab Gandhi
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, USA
| | - Athul Raj Raju
- Department of Medicine, Karuna Medical College, Chittur-Thathamangalam 678103, Kerala, India
| | - Vivek Joseph Varughese
- Department of Internal Medicine, Government Medical College, Thiruvananthapuram 695011, Kerala, India
| | - Geethu Jnaneswaran
- Department of Medicine, SUT Academy of Medical Sciences, Thiruvananthapuram 695028, Kerala, India
| | - Charu Agarwal
- Department of Medicine, Sri Siddhartha Medical College, Tumakuru 572107, Karnataka, India
| | - Bisharah Rizvi
- Department of Internal Medicine, Saint Agnes Medical Center, Fresno, CA 93720, USA
| | - Zeeshan Mansuri
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Puneet Gupta
- Department of Cardiology, Baptist Health Deaconess Madisonville, Madisonville, KY 42431, USA
| | - Gautam Kumar
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Rajesh Sachdeva
- Division of Cardiology, Atlanta VA Medical Center, 1670 Clairmont Rd., Decatur, GA 30033, USA
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Zhang L. Anxiety and depression in recurrent gastric cancer: Their prevalence and independent risk factors analyses. Medicine (Baltimore) 2021; 100:e28358. [PMID: 34941152 PMCID: PMC8702138 DOI: 10.1097/md.0000000000028358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 12/01/2021] [Indexed: 01/05/2023] Open
Abstract
Various anxiety and depression-related risk factors have been reported in cancer patients. However, little is known about the anxiety and depression-related risk factors in recurrent gastric cancer patients. Therefore, our aim was to investigate the prevalence and risk factors for anxiety and depression in recurrent gastric cancer patients.Totally 82 recurrent gastric cancer patients were consecutively recruited, and their clinical features were collected from hospital's electronic medical records. Besides, 80 newly diagnosed gastric cancer patients and 80 healthy controls were enrolled. Their anxiety and depression status was assessed using Hospital Anxiety and Depression Scale (HADS).The HADS-anxiety score (9.1 ± 3.4, 7.2 ± 3.0, 4.8 ± 2.7, respectively) and the percentage of anxiety patients (52.4%, 33.8%, 11.3%, respectively) were increased in recurrent gastric cancer patients compared to newly diagnosed gastric cancer patients and healthy controls; Also, the HADS-depression score (7.9 ± 3.1, 6.7 ± 2.6, 4.1 ± 2.8, respectively) and the percentage of depression patients (41.5%, 25.0%, 8.8%, respectively) had similar trends. Forward stepwise multivariate logistic regression revealed that age ≥60 years, diabetes, tumor-node-metastasis (TNM) stage at diagnosis, shorter time to recurrence and distant metastasis at recurrence were independent risk factors for anxiety occurrence, whereas age ≥60 years, diabetes, tumor location at diagnosis (cardia vs gastric antrum) and shorter time to recurrence were independent risk factors for depression occurrence.The prevalence of anxiety and depression is such high, and their relevant risk factors include age ≥60 years, diabetes and shorter time to recurrence in recurrent gastric cancer patients.
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Choi J, Chung J, Choi J. Exploring Impact of Marijuana (Cannabis) Abuse on Adults Using Machine Learning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10357. [PMID: 34639657 PMCID: PMC8508366 DOI: 10.3390/ijerph181910357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
Marijuana is the most common illicit substance globally. The rate of marijuana use is increasing in young adults in the US. The current environment of legalizing marijuana use is further contributing to an increase of users. The purpose of this study was to explore the characteristics of adults who abuse marijuana (20-49 years old) and analyze behavior and social relation variables related to depression and suicide risk using machine-learning algorithms. A total of 698 participants were identified from the 2019 National Survey on Drug Use and Health survey as marijuana dependent in the previous year. Principal Component Analysis and Chi-square were used to select features (variables) and mean imputation method was applied for missing data. Logistic regression, Random Forest, and K-Nearest Neighbor machine-learning algorithms were used to build depression and suicide risk prediction models. The results showed unique characteristics of the group and well-performing prediction models with influential risk variables. Identified risk variables were aligned with previous studies and suggested the development of marijuana abuse prevention programs targeting 20-29 year olds with a regular depression and suicide screening. Further study is suggested for identifying specific barriers to receiving timely treatment for depression and suicide risk.
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Affiliation(s)
- Jeeyae Choi
- School of Nursing, University of North Carolina, Wilmington, NC 28403, USA
| | - Joohyun Chung
- College of Nursing, University of Massachusetts, Amherst, MA 01002, USA; (J.C.); (J.C.)
| | - Jeungok Choi
- College of Nursing, University of Massachusetts, Amherst, MA 01002, USA; (J.C.); (J.C.)
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Quiros JA, Saps M. The Coming Storm: Cannabis Hyperemesis Syndrome in Adolescents. J Adolesc Health 2021; 68:223-224. [PMID: 33541594 DOI: 10.1016/j.jadohealth.2020.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 11/18/2022]
Affiliation(s)
- J Antonio Quiros
- Pediatric Therapeutic Endoscopy Program, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Mount Sinai Kravis Children's Hospital, New York, New York
| | - Miguel Saps
- Chief of Division of Pediatric Gastroenterology, Miller School of Medicine, Hepatology and Nutrition, University of Miami, Miami, Florida
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Abuhasira R, Novack V. Increased risk of cardiac arrhythmias with cannabis use - More studies are needed. Eur J Intern Med 2020; 80:14-15. [PMID: 32773275 DOI: 10.1016/j.ejim.2020.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Ran Abuhasira
- Cannabis Clinical Research Institute and Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Victor Novack
- Cannabis Clinical Research Institute and Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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