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Stroke risk increased within 24 hours of cocaine use
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SAN DIEGO — Cocaine use may substantially increase the risk for stroke within 24 hours in young adults, according to findings presented at the International Stroke Conference.
The risk for ischemic stroke associated with recent cocaine use is higher than that for diabetes, hypertension or current smoking, investigator Yu-Ching Cheng, PhD, of Veterans Affairs Maryland Health Care System and the University of Maryland School of Medicine, said at a press conference.
“With few exceptions, we believe every young stroke patient without a clear etiology should be screened for drug abuse at the time of hospital admission,” Cheng said.
The population-based, case-control study included young adults aged 15 to 49 years (53% white) recruited from the Baltimore/Washington, D.C., area between 1992 and 2008. Researchers studied 1,101 cases with ischemic stroke and 1,154 controls with no evidence of ischemic stroke. Each participant underwent a standardized interview about illicit drug use and other risk factors.
According to results presented at ISC, history of cocaine use was similar between the groups (cases, 28.1%; controls, 25.7%). The researchers reported no association between ischemic stroke and history of cocaine use for any subgroup.
However, after adjustment for age, sex and ethnicity, cocaine use within 24 hours was strongly associated with ischemic stroke (cases, 2.4%; controls, 0.4%; OR=6.4). This was a stronger association than history of diabetes (OR=3.5), history of hypertension (OR=2.8) or current smoking (OR=1.9), Cheng said.
When the researchers adjusted for age, current smoking status, sex and ethnicity, they found similar associations between ischemic stroke and cocaine use within 24 hours between white (OR=4.7; 95% CI, 0.5-42.6) and black adults (OR=4.6; 95% CI, 1.3-20). The link was higher in women than in men, but the difference was not statistically significant, Cheng said.
“Simply put, cocaine use markedly increases stroke risk … through elevated blood pressures, heart rates, and cardiac arrhythmias, all predisposing to stroke,” Cheng said. – by Erik Swain
For more information:
Cheng Y-C. Abstract WMP57. Presented at: International Stroke Conference 2014; Feb. 12-14, 2014; San Diego.
Disclosure: Cheng reports no relevant financial disclosures.
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Ralph L. Sacco, MD, MS, FAHA, FAAN
We know drug abuse is still a problem in the United States. It has been shown by this group before that drug abuse, including cocaine, is related to stroke risk. This is another wake-up call that cocaine use is still out there and still contributing to many strokes, particularly in younger people.
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