Myocardial infarction, stroke and cardiovascular mortality among migraine patients: a systematic review and meta-analysis

Ng, Chester Yan Hao; Tan, Benjamin Yong‐Qiang; Teo, Yao Neng; Syn, Nicholas; Leow, Aloysius Sheng‐Ting; Ho, Jamie Sin-Ying; Chan, Mark Y; Wong, Raymond Cc; Chai, Ping; Chan, Alan K. L.; Sharma, Vijay K; Yeo, Leonard Leong‐Litt; Sia, Ching‐Hui; Ong, Jonathan

doi:10.1007/s00415-021-10930-x

Cited by 35 publications

(32 citation statements)

References 74 publications

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“…According to a Danish population-based cohort study, migraine patients were found to have a higher risk of MI (OR 1.49, 95% CI: 1.36–1.64), ischemic stroke (OR 2.26, 95% CI: 2.11–2.41), and hemorrhagic stroke (OR 1.94, 95% CI: 1.68–2.23) after an 18-year follow-up ( 11 ), which was in line with the findings in the Nurses’ Health Study II of 115541 young- and middle-aged female nurses that migraine was positively associated with MI (OR 1.39, 95% CI: 1.18–1.64), stroke (OR 1.62, 95% CI: 1.37–1.92), angina/coronary revascularization (OR 1.73, 95% CI: 1.29–2.32), and cardiovascular mortality (OR 1.37, 95% CI: 1.02–1.83) ( 10 ). A recently published meta-analysis of 18 prospective cohort studies incorporating 1.6 million migraineurs documented that migraine was associated with a greater risk of MI and stroke (including unspecified, ischemic, and hemorrhagic) and that MA was associated with a higher risk of cardiovascular mortality, with a moderate to severe degree of heterogeneity for the cardiovascular outcomes existing in these studies being fundamentally attributed to the presence of aura ( 30 ). Generally speaking, estimated ORs in this study were much higher than those in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Association between migraine and cardiovascular disease: A cross-sectional study

Wang

Mao

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCardiovascular disease (CVD) poses a tremendous threat to global health, giving rise to exceedingly high morbidity and mortality among patients. A migraine is a common neurological disorder characterized by recurrent attacks of severe headache, while its cardiovascular burden remains unclear. Therefore, this study aims to investigate whether migraine is associated with CVD.MethodsThe cross-sectional data of 5,692 subjects aged 20 or above was obtained from the National Health and Nutrition Examination Survey (NHANES) 1999–2004. To determine whether migraine is associated with CVD, weighted logistic regression models were used. In a subsequent subgroup analysis, several confounding factors were also explored to investigate the association between migraine and CVD.ResultsIn total, 5,692 subjects were enrolled in this study, with the prevalence of CVD being 13.3%. Participants with CVD tended to be older, male, non-Hispanic whites, more educated, former smokers, and alcohol drinkers, and had a higher waist circumference, less physical activity, a higher level of triglyceride and creatinine as well as a lower level of high-density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) (all P < 0.05). Considering all potential confounders, migraine was associated with a higher risk of CVD [odds ratios (ORs) 2.77; 95% confidence intervals (CIs): 1.56–4.90]. Subgroup analysis showed a higher risk of CVD in females, those older than 60 years, with a lower body mass index (BMI) level (≤ 30 kg/m2), a higher level of eGFR (> 90 mL/min/1.73 m2), hypertension and hyperlipidemia and without diabetes.ConclusionIn summary, our study revealed a positive association between migraine with CVD in a nationally representative US adult population. Our findings highlighted that migraine should be considered an important risk factor for CVD.

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Section: Discussionmentioning

confidence: 99%

Association between migraine and cardiovascular disease: A cross-sectional study

Wang

Mao

et al. 2022

Front. Cardiovasc. Med.

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“…These multifaceted mechanisms are also shared with a plethora of other clinical conditions which are comorbid with migraine (4). Among these disorders, acute vascular accidents are probably the most dreaded event in the lifetime of patients with migraine (5). Stroke risk is more consistent in patients with migraine with aura (MA), where, while the absolute risk of ischemic stroke is low, the relative risk is doubled when compared to the general population (6).…”

Section: Introductionmentioning

confidence: 99%

Stroke territory and atherosclerosis in ischemic stroke patients with a history of migraine with aura

Altamura

Viticchi²,

Rizzo³

et al. 2023

Front. Neurol.

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IntroductionThe mechanisms subtending the increased stroke risk in migraine with aura (MA) are not fully understood. Our study aims to evaluate if the clinical profile in stroke patients with MA differentiates from those without MA.MethodsWe retrieved the prospective registered electronic clinical dossiers of adult patients younger than 60 years with acute ischemic stroke admitted in four hospitals between January 2016 and June 2022. Patients were classified by the history of MA (MA+ and MA–).ResultsWe identified 851 stroke patients (59 MA+, 6.9%). Compared to MA−, MA+ patients were characterized by younger age (44.0 ± 10.6 vs 50.1 ± 8.2 years), female sex (59.3% vs 29.0%), and affected by cryptogenic (OR 2.594 95% CI 1.483–4.537), and cerebellar stroke (OR 3.218 95% CI 1.657–6.250; p ≤ 0.001 for all comparisons). After adjusting for age and sex, MA+ patients presented less frequently hypertension (OR 0.349 95% CI 0.167–0.470; p=0.005) and dyslipidemia (OR 0.523 95% CI 0.280–0.974; p = 0.041). After adjusting also for risk factors, the MA+ group had less frequently symptomatic large vessel stenosis (OR 0.126 95% CI 0.017–0,924; p = 0.042) and clinical atherosclerosis (OR 0.103 95% CI 0.014–0.761; p = 0.026), while intima–media thickness did not differ (p = 0.395).DiscussionCryptogenic and cerebellar stroke and fewer vascular risk factors and clinical atherosclerosis seem to characterize stroke patients with MA.

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“…1,2 A meta-analysis of prospective cohort studies showed that migraine was associated with increased risk of ischemic stroke. 3 However, few studies have investigated the association of migraine with post-stroke outcome. 4,5 Establishing causality between liability to migraine and post-stroke outcome could have significant clinical implications, with a positive association suggesting that migraine treatment may improve post-stroke recovery.…”

Section: Introductionmentioning

confidence: 99%

Genetic liability to migraine and functional outcome after ischemic stroke

Wang

Daghlas

Zhang

et al. 2023

European Stroke Journal

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Background and purpose: To evaluate the association of genetic liability to migraine with functional outcome after ischemic stroke using Mendelian randomization. Methods: Genetic proxies for migraine were obtained from the largest genome-wide association study meta-analysis of 102,084 migraine cases and 771,257 controls. Genetic associations with functional outcome after ischemic stroke were obtained from the Genetics of Ischemic Stroke Functional Outcome network study ( N = 6021). Poor functional outcome after ischemic stroke was defined as a score of 3–6 on the modified Rankin scale at 3 months ( N = 2280). The inverse-variance weighted method was used to estimate the association of genetic liability to migraine with functional outcome, and we performed sensitivity analyses to assess the robustness of results. Results: Genetic liability to migraine was associated with poor functional outcome after ischemic stroke (odds ratio of poor functional outcome per doubling in migraine odds 1.22, 95% confidence interval 1.02–1.45, p = 0.031). This association remained directionally consistent across sensitivity analyses. Conclusions: This study provides genetic support that migraine is associated with poor functional outcome after ischemic stroke. These findings warrant further follow-up and, if replicated, may have clinical implications for post-stroke recovery.

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Myocardial infarction, stroke and cardiovascular mortality among migraine patients: a systematic review and meta-analysis

Cited by 35 publications

References 74 publications

Association between migraine and cardiovascular disease: A cross-sectional study

Association between migraine and cardiovascular disease: A cross-sectional study

Stroke territory and atherosclerosis in ischemic stroke patients with a history of migraine with aura

Genetic liability to migraine and functional outcome after ischemic stroke

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