Acute Cocaine Exposure and Cerebrovascular Diseases: A Retrospective Clinical Study and Literature Review

Figure
Xiaohong Si and Jin Jun Luo
 

Abstract

Objective: To evaluate cocaine as a risk factor for Cerebrovascular Diseases (CVD).

Introduction: Illicit substance consumption is an independent risk factor for CVD, however studies on such substances, particularly cocaine, and their relationship to the occurrence of CVD in gender, age, and race are sparse.

Methods: A retrospective chart review of the patients with International Classification of Diseases, 9th revision (ICD-9) diagnostic code of 430-437 between January 1, 2003 to December 31, 2005 was performed. Three major CVD including Subarachnoid Hemorrhage (SAH, ICD-9 code: 430), Intracerebral Hemorrhage (ICH, 431), and cerebral artery occlusion with infarction (Infarct, 434.91) were included. Urine Drug Screen (UDS) was performed on admission. Patients who did not receive UDS were excluded. Patients were divided into Cocaine-Positive (CP) and Cocaine-Negative (CN) groups and further subgroups based on the gender, age, race, and comorbidities.

Results: 562 CVD patients who had UDS were included. They were grouped into SAH (17.1%), ICH (31.3%) and infarct (51.6%) and then further sub-grouped as follows: SAH-CP: (15.6% = 15/96, patients/ total numbers of the group patients; Male/Female = 7/8, age: 46.4 ± 9.4 years, mean ± SD) and SAH-CN (84.3% = 81/96, M/F = 48/33, 45.1 ± 14.2); ICH-CP (14.8% = 26/176, M/F = 8/18, 48.5 ± 7.4) and ICH-CN (85.2% = 150/176, M/F = 58/92, 54.7 ± 14.5); and infarcts-CP (10.3% = 30/290, M/F = 12/18, 45.3 ± 6.5) and infarcts-CN (89.7% = 260/290, M/F = 110/150, 53.4 ± 15.5). Our findings confirmed that cocaine: 1) facilitates the occurrence of ICH and infarcts, particularly in patients younger than 50 years (p < 0.05); 2) promotes ICH in the African American than non-African American ethnicity (p < 0.05); 3) displays no significant difference in genders and in subjects with or without cardiomegaly in promoting CVD. Discussion/Conclusion: Cocaine may play discrete roles in promoting the onset of CVD in gender, age, race and comorbidities.

Published on: February 02, 2018
doi: 10.17756/jnen.2018-032
Citation: Si X, Luo JJ. 2018. Acute Cocaine Exposure and Cerebrovascular Diseases: A Retrospective Clinical Study and Literature Review. J Neurol Exp Neurosci 4(1): 1-6.