Cocaine Use and White Matter Hyperintensities in Homeless and Unstably Housed Women.
Cocaine Use and White Matter Hyperintensities in Homeless and Unstably Housed Women.
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DOI：
10.1016/j.jstrokecerebrovasdis.2021.105675
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Hess CP
中科院分区：
文献类型：
--
作者：
Riley ED;Chow FC;Josephson SA;Dilworth SE;Lynch KL;Wade AN;Braun C;Hess CP
在几项研究中，可卡因的使用与中风有关。然而，很少有研究考虑可卡因使用对中风机制如小血管疾病（SVD）的影响。我们进行了一项研究，以评估毒理学证实的多种药物（包括可卡因）的使用与SVD标志物白色高信号（WMH）之间的关联。我们在一项更大的队列研究（N=245）中进行了一项巢式病例对照研究（n=30），研究对象是从旧金山弗朗西斯科社区招募的无家可归和住房不稳定的妇女。参与者完成了六个月的研究访问，包括访谈，抽血，生命体征评估和基线脑部MRI。我们研究了毒理学证实的多种物质（包括可卡因，甲基苯丙胺，海洛因，酒精和烟草）的使用与MRI上识别的WMH之间的关联。研究参与者的平均年龄为53岁，70%的参与者是少数民族妇女，86%有可卡因使用史。脑MRI显示存在WMH（即，Fazekas评分>0）。可卡因毒理学阳性的女性中WMH的几率显著较高（比值比=7.58，p=0.01），但其他药物毒理学阳性或有其他几种脑血管危险因素的女性中WMH的几率不高。超过一半的无家可归和住房不稳定的妇女有WMH的证据。在这一人群中，可卡因的使用是非常普遍的，并且是WMH的显著相关性，而几个传统的CVD风险因素则不是。在脑血管风险计算器中包括可卡因使用可能会改善高危人群的卒中风险预测，并需要进一步研究。
Cocaine use has been linked to stroke in several studies. However, few studies have considered the influence of cocaine use on stroke mechanisms such as small vessel disease (SVD). We conducted a study to assess associations between the toxicology-confirmed use of multiple drugs, including cocaine, and a marker of SVD, white matter hyperintensities (WMH). We conducted a nested case-control study (n=30) within a larger cohort study (N=245) of homeless and unstably housed women recruited from San Francisco community venues. Participants completed six monthly study visits consisting of an interview, blood draw, vital sign assessment and baseline brain MRI. We examined associations between toxicology-confirmed use of multiple substances, including cocaine, methamphetamine, heroin, alcohol and tobacco, and WMH identified on MRI. Mean study participant age was 53 years, 70% of participants were ethnic minority women and 86% had a history of cocaine use. Brain MRIs indicated the presence of WMH (i.e., Fazekas score>0) in 54% (18/30) of imaged participants. The odds of WMH were significantly higher in women who were toxicology-positive for cocaine (Odd Ratio=7.58, p=0.01), but not in women who were toxicology-positive for other drugs or had several other cerebrovascular risk factors. Over half of homeless and unstably housed women showed evidence of WMH. Cocaine use is highly prevalent and a significant correlate of WMH in this population, while several traditional CVD risk factors are not. Including cocaine use in cerebrovascular risk calculators may improve stroke risk prediction in high-risk populations and warrants further investigation.
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影响因子：
4
作者：
Chong, JY;Sacco, RL
通讯作者：
Sacco, RL
DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Debette S;Markus HS
通讯作者：
Markus HS
影响因子：
37.8
作者：
Hsue, PY;Salinas, CL;Waters, DD
通讯作者：
Waters, DD
影响因子：
3.8
作者：
Lee W;Hwang SH;Choi H;Kim H
通讯作者：
Kim H
影响因子：
8.3
作者：
KIYOHARA, Y;KATO, I;FUJISHIMA, M
通讯作者：
FUJISHIMA, M