Urine toxicology screening in an urban stroke and TIA population

Silver, Brian; Miller, Daniel J.; Jankowski, Michelle; Murshed, Nawaf; García, Patricia; Penstone, Patricia; Straub, Melissa; Logan, Sean P.; Sinha, Anita; Morris, Daniel C.; Katramados, Angelos; Russman, Andrew; Mitsias, Panayiotis; Schultz, Lonni

doi:10.1212/wnl.0b013e318293e2fe

Cited by 27 publications

(20 citation statements)

References 28 publications

(15 reference statements)

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“…In agreement with the previous study [30], our findings also confirmed that cocaine exposure promotes more ICH, but not ischemic stroke, in AA when compared to non-AA, supporting the claim that the AA ethnicity has a higher incidence of illicit drug-related CVD [30].…”

Section: Discussionsupporting

confidence: 92%

“…A high risk of stroke occurs shortly after use of cocaine as the onset of stroke symptoms was usually found immediately or within 3 hours after cocaine use [1,11]. Cocaine-induced hemodynamic changes may be related to ICH [29], particularly in active cocaine users [30], with higher risk of aneurysm rupture causing subarachnoid hemorrhage [30], worse functional outcomes and higher mortality when compared to non-cocaine-users [31]. Autopsy studies demonstrated a higher incidence of hypertensive cardiovascular disease in cocaine-induced hemorrhagic stroke [32].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Si¹,

Luo²

2018

J Neurol Exp Neurosci

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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

Si¹,

Luo²

2018

J Neurol Exp Neurosci

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“…The oldest patient with a positive test was 71 years of age, and 9% of all patients ≥50 years of age tested positive for cocaine. 457 Proposed mechanisms of cocaine-associated ischemic stroke include vasoconstriction, increased platelet aggregation, accelerated atherosclerosis, and vascular cell death resulting in vessel weakening and dissection. The largest available published series on the use of alteplase in cocaineassociated ischemic stroke comprised 29 patients who were compared with 75 alteplase-treated patients with ischemic stroke without drug use.…”

Section: Drug Use (Cocaine)mentioning

confidence: 99%

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Demaerschalk¹,

Kleindorfer²,

Adeoye³

et al. 2016

Stroke

583

237

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Purpose-To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 24, 2015, and the American Heart Association Executive Committee on October 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com.The online-only Data Supplement, which contains literature search strategies and Figures A, B, and C, is available with this article at http://circ. ahajournals.org/lookup/suppl/doi:10.1161/STR.0000000000000086/-/DC1.The American Heart Association requests that this document be cited as follows: Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, Khalessi AA, Levy EI, Palesch YY, Prabhakaran S, Saposnik G, Saver JL, Smith EE; on behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention. Scientific rational...

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“…In such cases, direct questioning is of value in all patients, with urine testing of value in some. Unfortunately, in the absence of standardized guidelines for urine testing in the context of suspected cocaine-related cardiovascular events, toxicology screening appears to be performed most frequently in young black males [65], raising concerns regarding issues of health and treatment disparity [66]. The rate of self-report of illicit drug use is just over 50% in patients with a positive toxicology screen upon presentation to the emergency department with chief complaint of chest pain [67], suggesting that urine screening may be a valuable and under-utilized tool.…”

Section: Diagnosismentioning

confidence: 99%