Implicación de la cocaína en la patología vascular cerebral / Involvement of cocaine in cerebral vascular pathology

Objetivo. Describir la implicación de la cocaína en la patología vascular cerebral en pacientes jóvenes. Pacientes y métodos. Es un estudio descriptivo del papel de la cocaína en pacientes con ictus agudo menores de 50 años ingresados en el servicio de neurología durante cuatro años. Se analizan 18 pacientes con niveles de cocaína positivos en el momento del ingreso y 79 pacientes con niveles negativos. Se recogen y analizan distintas variables que definen el perfil de riesgo vascular, características del ictus y morbimortalidad asociada a éstos. Resultados. Se obtiene un predominio de varones y mayor proporción de factores de riesgo vascular no significativa en el grupo control (55,6% frente a 64,6%). El grupo de consumidores presenta de manera significativa una menor edad media (35,2 ± 8,9 frente a 41,5 ± 7,7 años), mayor consumo de tóxicos (tabaco, alcohol y cannabis), hiperCKemia (27,8% frente a 5,1%) y trastorno psiquiátrico (16,7% frente a 3,8%) (p < 0,05). Predomina el subtipo de ictus isquémico en territorio anterior para ambos grupos. Hay una clara tendencia a la normalidad de las pruebas complementarias, mayor índice de complicaciones (33,3% frente a 15,2%) y mortalidad (11,1% frente a 3,8%) en los consumidores (p > 0,05). Conclusiones. La cocaína es un factor de riesgo que hay que tener en cuenta en adultos jóvenes, asociado a ictus a edades más tempranas de lo habitual, con tendencia a la normalidad de las pruebas complementarias y una mayor morbimortalidad hospitalaria (AU)

Aim. To describe the involvement of cocaine in cerebral vascular pathology in young patients. Patients and methods. The work consists in a descriptive study of the role of cocaine in patients with acute stroke under the age of 50 years admitted to the neurology service over a period of four years. Eighteen patients with positive levels of cocaine on admission and 79 patients with negative levels were analysed. Different variables that define the profile of vascular risk, characteristics of the stroke and the morbidity and mortality associated to them are collected and analysed. Results. Males were predominant and there was a non-significant higher proportion of vascular risk factors in the control group (55.6% versus 64.6%). The group of consumers presented a significantly lower mean age (35.2 ± 8.9 versus 41.5 ± 7.7 years), higher consumption of toxic substances (tobacco, alcohol and cannabis), hyperCKemia (27.8% versus 5.1%) and psychiatric disorders (16.7% versus 3.8%) (p < 0.05). The ischaemic stroke in the anterior territory subtype was predominant in both groups. There was a clear tendency towards normality in complementary tests and a higher rate of complications (33.3% versus 15.2%) and mortality (11.1% versus 3.8%) among consumers (p > 0.05). Conclusions. Cocaine is a risk factor that must be taken into account in young adults: it is associated to stroke at earlier ages than is considered normal, with a tendency towards normality in complementary tests and a higher rate of hospital morbidity and mortality (AU)

[Involvement of cocaine in cerebral vascular pathology]. / Implicación de la cocaína en la patología vascular cerebral.

AIM: To describe the involvement of cocaine in cerebral vascular pathology in young patients. PATIENTS AND METHODS: The work consists in a descriptive study of the role of cocaine in patients with acute stroke under the age of 50 years admitted to the neurology service over a period of four years. Eighteen patients with positive levels of cocaine on admission and 79 patients with negative levels were analysed. Different variables that define the profile of vascular risk, characteristics of the stroke and the morbidity and mortality associated to them are collected and analysed. RESULTS: Males were predominant and there was a non-significant higher proportion of vascular risk factors in the control group (55.6% versus 64.6%). The group of consumers presented a significantly lower mean age (35.2 ± 8.9 versus 41.5 ± 7.7 years), higher consumption of toxic substances (tobacco, alcohol and cannabis), hyperCKemia (27.8% versus 5.1%) and psychiatric disorders (16.7% versus 3.8%) (p < 0.05). The ischaemic stroke in the anterior territory subtype was predominant in both groups. There was a clear tendency towards normality in complementary tests and a higher rate of complications (33.3% versus 15.2%) and mortality (11.1% versus 3.8%) among consumers (p > 0.05). CONCLUSIONS: Cocaine is a risk factor that must be taken into account in young adults: it is associated to stroke at earlier ages than is considered normal, with a tendency towards normality in complementary tests and a higher rate of hospital morbidity and mortality.