Abstract Details

Title Clinical Characteristics of Methamphetamine Associated Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-013

Objective In this single center study, we characterize the effects of Methamphetamine (MA) on acute ischemic stroke (AIS) in terms of demographics, presentation, and clinical significance.

Background MA abuse represents a significant public health problem with increasing incidence of usage reported worldwide. AIS has been associated with MA use, however its effects have been underreported.

Design/Methods We performed a retrospective analysis of 654 patients admitted to UC Davis Medical Center from 2016-2017 with primary diagnosis of AIS. Patients presenting characteristics, suspected stroke etiologies based on TOAST criteria, and clinical outcomes were compared between AIS with and without positive urine drug screen for MA.

Results Fifty patients with methamphetamine positive (MA+) AIS and 252 patients with methamphetamine negative (MA-) AIS were identified. In general, patients with MA+ had a more severe presentation with higher systolic pressures (175.1 vs 157.6, p<0.001) and diastolic pressures (105 vs 86.23, p<0.001). Overall, the two groups did not differ in terms of presenting NIHSS, rates of TPA administration, length of stay, or ICU length of stay. In terms of etiologies, MA+AIS had a significantly higher incidence of small vessel strokes (0.41 vs 0.20, p= 0.0017) whereas large vessel occlusions were significantly more predominant in MA-AIS (0.22 vs 0.10, p=0.04). Analysis of MRI burden of deep white matter (DWM) lesions based on Fazekas scale demonstrated significantly lower proportion of moderate to severe disease burn in MA +AIS (0.17 vs 0.49, p=0.0001).

Conclusions

MA+AIS have an earlier age of onset with significantly higher presenting blood pressures while maintaining similar initial NIHSS, ICU length of stay, and hospital stay compared to MA-AIS. MA+AIS presented with small vessel strokes and significantly lower burden of deep white matter disease. This suggests cerebral small vessels may be more sensitive to the sympathomimetic nature of MA that may be driving transient hypertension and cerebral vasoconstriction as potential pathogenesis.

Authors/Disclosures
Sandeep S. Walia, MD (University of California, Davis) PRESENTER	No disclosure on file
Kwan Ng, MD, PhD (UC Davis Health Dept of Neurology)	Dr. Ng has nothing to disclose.

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