Acute use of cocaine can cause an elevated risk of early-onset ischemic stroke, research confirms.
While there has long been an established temporal association between cocaine use and ischemic stroke, few studies have explored the association by timing, route, and frequency of use.
In this study published in Stroke, Yu-Ching Cheng, PhD, of the University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, and colleagues assessed the relationship between cocaine use and young-onset ischemic stroke in 1090 cases (aged 15-49 years) and 1154 controls.
Twenty-eight percent of cases and 26% of controls reported ever using cocaine, but this was not associated with stroke. However, acute cocaine use in the previous 24 hours was strongly associated with increased risk of stroke after adjusting for age, sex, and race (OR, 6.4; 95% CI, 2.2–18.6). In acute users, the smoking route was associated with an adjusted OR of 7.9 (95% CI, 1.8-35.0) compared to those who used the inhalation route, which was associated with an OR of 3.5 (95% CI, 0.7-16.9). After adjusting for current alcohol use, smoking, and hypertension, the OR for acute use of cocaine by any route was 5.7 (95% CI, 1.7-19.7). Notably, 14 of the 26 patients who reported cocaine use within the last 24 hours used within 6 hours of their ischemic event.
Ultimately, the data confirms a causal relationship between acute use of cocaine and early-onset ischemic stroke.