Intravenous tissue plasminogen activator in patients with cocaine-associated acute ischemic stroke.
OBJECTIVE
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.
Martin-Schild
Sheryl
S
Albright
Karen C
KC
Misra
Vivek
V
Philip
Maria
M
Barreto
Andrew D
AD
Hallevi
Hen
H
Grotta
James C
JC
Savitz
Sean I
SI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000209:etiology*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D055815:Young Adult
D010959:Tissue Plasminogen Activator