Cocaine use and risk of ischemic stroke in young adults

Yu Ching Cheng, Kathleen A. Ryan, Saad A. Qadwai, Jay Shah, Mary J. Sparks, Marcella A. Wozniak, Barney Stern, Michael S. Phipps, Carolyn A. Cronin, Laurence S. Magder, John W. Cole, Steven J. Kittner

Research output: Contribution to journalArticle

Abstract

Background and Purpose-Although case reports have long identified a temporal association between cocaine use and ischemic stroke (IS), few epidemiological studies have examined the association of cocaine use with IS in young adults, by timing, route, and frequency of use. Methods-A population-based case-control study design with 1090 cases and 1154 controls was used to investigate the relationship of cocaine use and young-onset IS. Stroke cases were between the ages of 15 and 49 years. Logistic regression analysis was used to evaluate the association between cocaine use and IS with and without adjustment for potential confounders. Results-Ever use of cocaine was not associated with stroke with 28% of cases and 26% of controls reporting ever use. In contrast, acute cocaine use in the previous 24 hours was strongly associated with increased risk of stroke (age-sex-race adjusted odds ratio, 6.4; 95% confidence interval, 2.2-18.6). Among acute users, the smoking route had an adjusted odds ratio of 7.9 (95% confidence interval, 1.8-35.0), whereas the inhalation route had an adjusted odds ratio of 3.5 (95% confidence interval, 0.7-16.9). After additional adjustment for current alcohol, smoking use, and hypertension, the odds ratio for acute cocaine use by any route was 5.7 (95% confidence interval, 1.7-19.7). Of the 26 patients with cocaine use within 24 hours of their stroke, 14 reported use within 6 hours of their event. Conclusions-Our data are consistent with a causal association between acute cocaine use and risk of early-onset IS.

Original languageEnglish (US)
Pages (from-to)918-922
Number of pages5
JournalStroke
Volume47
Issue number4
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Cocaine
Young Adult
Stroke
Odds Ratio
Confidence Intervals
Smoking
Inhalation
Case-Control Studies
Epidemiologic Studies
Logistic Models
Regression Analysis
Alcohols
Hypertension
Population

Keywords

  • Cocaine
  • Hypertension
  • Odds ratio
  • Stroke
  • Young adult

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Cheng, Y. C., Ryan, K. A., Qadwai, S. A., Shah, J., Sparks, M. J., Wozniak, M. A., ... Kittner, S. J. (2016). Cocaine use and risk of ischemic stroke in young adults. Stroke, 47(4), 918-922. https://doi.org/10.1161/STROKEAHA.115.011417

Cocaine use and risk of ischemic stroke in young adults. / Cheng, Yu Ching; Ryan, Kathleen A.; Qadwai, Saad A.; Shah, Jay; Sparks, Mary J.; Wozniak, Marcella A.; Stern, Barney; Phipps, Michael S.; Cronin, Carolyn A.; Magder, Laurence S.; Cole, John W.; Kittner, Steven J.

In: Stroke, Vol. 47, No. 4, 01.01.2016, p. 918-922.

Research output: Contribution to journalArticle

Cheng, YC, Ryan, KA, Qadwai, SA, Shah, J, Sparks, MJ, Wozniak, MA, Stern, B, Phipps, MS, Cronin, CA, Magder, LS, Cole, JW & Kittner, SJ 2016, 'Cocaine use and risk of ischemic stroke in young adults', Stroke, vol. 47, no. 4, pp. 918-922. https://doi.org/10.1161/STROKEAHA.115.011417
Cheng YC, Ryan KA, Qadwai SA, Shah J, Sparks MJ, Wozniak MA et al. Cocaine use and risk of ischemic stroke in young adults. Stroke. 2016 Jan 1;47(4):918-922. https://doi.org/10.1161/STROKEAHA.115.011417
Cheng, Yu Ching ; Ryan, Kathleen A. ; Qadwai, Saad A. ; Shah, Jay ; Sparks, Mary J. ; Wozniak, Marcella A. ; Stern, Barney ; Phipps, Michael S. ; Cronin, Carolyn A. ; Magder, Laurence S. ; Cole, John W. ; Kittner, Steven J. / Cocaine use and risk of ischemic stroke in young adults. In: Stroke. 2016 ; Vol. 47, No. 4. pp. 918-922.
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abstract = "Background and Purpose-Although case reports have long identified a temporal association between cocaine use and ischemic stroke (IS), few epidemiological studies have examined the association of cocaine use with IS in young adults, by timing, route, and frequency of use. Methods-A population-based case-control study design with 1090 cases and 1154 controls was used to investigate the relationship of cocaine use and young-onset IS. Stroke cases were between the ages of 15 and 49 years. Logistic regression analysis was used to evaluate the association between cocaine use and IS with and without adjustment for potential confounders. Results-Ever use of cocaine was not associated with stroke with 28{\%} of cases and 26{\%} of controls reporting ever use. In contrast, acute cocaine use in the previous 24 hours was strongly associated with increased risk of stroke (age-sex-race adjusted odds ratio, 6.4; 95{\%} confidence interval, 2.2-18.6). Among acute users, the smoking route had an adjusted odds ratio of 7.9 (95{\%} confidence interval, 1.8-35.0), whereas the inhalation route had an adjusted odds ratio of 3.5 (95{\%} confidence interval, 0.7-16.9). After additional adjustment for current alcohol, smoking use, and hypertension, the odds ratio for acute cocaine use by any route was 5.7 (95{\%} confidence interval, 1.7-19.7). Of the 26 patients with cocaine use within 24 hours of their stroke, 14 reported use within 6 hours of their event. Conclusions-Our data are consistent with a causal association between acute cocaine use and risk of early-onset IS.",
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AU - Stern, Barney

AU - Phipps, Michael S.

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