BACKGROUND AND PURPOSE: The safety of thrombolytic therapy in patients with cocaine-associated acute ischemic stroke (CIS) is unknown. METHODS: We conducted a retrospective review of patients with CIS who presented to our stroke center. Thrombolytic treatment was compared between cocaine-positive (n=29) and cocaine-negative (n=75) patients. We also compared patients with CIS treated with tissue plasminogen activator versus those who did not receive tissue plasminogen activator (n=58). Safety outcomes were determined by the incidence of symptomatic intracerebral hemorrhage, in-hospital mortality, and modified Rankin Scale at hospital discharge. RESULTS: There were no complications in tissue plasminogen activator-treated patients with CIS. Cocaine-positive and cocaine-negative treated patients had similar stroke severity and safety outcomes. Patients with CIS treated with tissue plasminogen activator had more severe strokes on baseline National Institutes of Health Stroke Scale but similar safety outcomes compared with nontreated patients with CIS. CONCLUSIONS: Thrombolytic therapy for CIS appears to be safe in this small study. Further research is needed to more definitively assess safety and efficacy of tissue plasminogen activator for CIS.
BACKGROUND AND PURPOSE: The safety of thrombolytic therapy in patients with cocaine-associated acute ischemic stroke (CIS) is unknown. METHODS: We conducted a retrospective review of patients with CIS who presented to our stroke center. Thrombolytic treatment was compared between cocaine-positive (n=29) and cocaine-negative (n=75) patients. We also compared patients with CIS treated with tissue plasminogen activator versus those who did not receive tissue plasminogen activator (n=58). Safety outcomes were determined by the incidence of symptomatic intracerebral hemorrhage, in-hospital mortality, and modified Rankin Scale at hospital discharge. RESULTS: There were no complications in tissue plasminogen activator-treated patients with CIS. Cocaine-positive and cocaine-negative treated patients had similar stroke severity and safety outcomes. Patients with CIS treated with tissue plasminogen activator had more severe strokes on baseline National Institutes of Health Stroke Scale but similar safety outcomes compared with nontreated patients with CIS. CONCLUSIONS: Thrombolytic therapy for CIS appears to be safe in this small study. Further research is needed to more definitively assess safety and efficacy of tissue plasminogen activator for CIS.
Authors: James McCord; Hani Jneid; Judd E Hollander; James A de Lemos; Bojan Cercek; Priscilla Hsue; W Brian Gibler; E Magnus Ohman; Barbara Drew; George Philippides; L Kristin Newby Journal: Circulation Date: 2008-03-17 Impact factor: 29.690
Authors: G Bartzokis; M Beckson; D B Hance; P H Lu; J A Foster; J Mintz; W Ling; P Bridge Journal: Biol Psychiatry Date: 1999-05-01 Impact factor: 13.382
Authors: S R Levine; J C Brust; N Futrell; K L Ho; D Blake; C H Millikan; L M Brass; P Fayad; L R Schultz; J F Selwa Journal: N Engl J Med Date: 1990-09-13 Impact factor: 91.245
Authors: S R Levine; J C Brust; N Futrell; L M Brass; D Blake; P Fayad; L R Schultz; C H Millikan; K L Ho; K M Welch Journal: Neurology Date: 1991-08 Impact factor: 9.910
Authors: Tareq S Almaghrabi; Mark M McDonald; Chunyan Cai; Mohammed H Rahbar; H Alex Choi; Kiwon Lee; Neeraj S Naval; James C Grotta; Tiffany R Chang Journal: Int J Cerebrovasc Dis Stroke Date: 2019-01-18