Prevalence of ischemic stroke and atrial fibrillation in young patients with migraine national inpatient sample analysis

Kuybu, Okkes; Amireh, Abdallah; Davis, Debra; Kelley, Roger E.; Javalkar, Vijayakumar

doi:10.1016/j.jstrokecerebrovasdis.2020.104972

Cited by 8 publications

(18 citation statements)

References 24 publications

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“…The association between headache disorders, most of all migraine, and Cardiovascular Diseases (CVDs) is well known since more than 40 years. A wide range of studies have revealed a link between migraine and hypertension, stroke, ischemic heart disease, patent foramen ovale and other cardiovascular diseases, as well as the role of migraine as a risk factors for several CVDs [ 36 , 50 ]. Females aged 45 or less suffering from migraine with aura are exposed to an increased risk of stroke, particularly if smokers and if under oral contraceptives [ 186 ], and to an increased incidence of major CVD events, particularly if smokers and if they have comorbidities with hypertension and diabetes [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our results show that for some conditions, prevalence among headache sufferers was higher than in GBD-2019 estimates, which leads to concluding that headaches might be both a cause or a consequence of these comorbidities. For example, migraine can be a risk factor for several CVDs [ 36 , 50 ]: thus it is not surprising that the pooled proportion of ischemic heart disease and of stroke/cerebrovascular conditions was higher among headache sufferers than among the general population. Another note can be made for comorbidities with conditions with a relevant pain component, such as back pain.…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities of primary headache disorders: a literature review with meta-analysis

Caponnetto

Deodato

Robotti³

et al. 2021

J Headache Pain

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Background Primary headache disorders are common and burdensome conditions. They are associated to several comorbidities, such as cardiovascular or psychiatric ones, which, in turn, contribute to the global burden of headache. The aim of this study is to provide a comprehensive description of the pooled prevalence of comorbidities of primary headache disorders using a meta-analytical approach based on studies published between 2000 and 2020. Methods Scopus was searched for primary research (clinical and population studies) in which medical comorbidities were described in adults with primary headache disorders. Comorbidities were extracted using a taxonomy derived from the Global Burden of Disease (GBD) study. We compared prevalence of comorbidities among headache sufferers against general population using GBD-2019 estimates, and compared comorbidities’ proportions in clinical vs. population studies, and by age and gender. Results A total of 139 studies reporting information on 4.19 million subjects with primary headaches were included: in total 2.75 million comorbidities were reported (median per subject 0.64, interquartile range 0.32–1.07). The most frequently addressed comorbidities were: depressive disorders, addressed in 51 studies (pooled proportion 23 %, 95 % CI 20–26 %); hypertension, addressed in 48 studies (pooled proportion 24 %, 95 % CI 22–26 %); anxiety disorders addressed in 40 studies (pooled proportion 25 %, 95 % CI 22–28 %). For conditions such as anxiety, depression and back pain, prevalence among headache sufferers was higher than in GBD-2109 estimates. Associations with average age and female prevalence within studies showed that hypertension was more frequent in studies with higher age and less females, whereas fibromyalgia, restless leg syndrome, and depressive disorders were more frequent in studies with younger age and more female. Conclusions Some of the most relevant comorbidities of primary headache disorders – back pain, anxiety and depression, diabetes, ischemic heart disease and stroke – are among the most burdensome conditions, together with headache themselves, according to the GBD study. A joint treatment of headaches and of these comorbidities may positively impact on headache sufferers’ health status and contribute to reduce the impact of a group of highly burdensome diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comorbidities of primary headache disorders: a literature review with meta-analysis

Caponnetto

Deodato

Robotti³

et al. 2021

J Headache Pain

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“…A large retrospective cross‐sectional study explored the prevalence of ischaemic stroke and atrial fibrillation in 834,875 migraine patients [39]. 4.9% had migraine with aura, 94.9% migraine without aura; mean age was 33 years.…”

Section: Resultsmentioning

confidence: 99%

“…One duplicate was identified. Based on the abstract, 32 articles met inclusion but not exclusion criteria [4,9–40]. Of these, 11 [9–19] were excluded since they reported atrial fibrillation after closure of atrial septal disorders.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining 21 [4,20–36,38–40] plus one case series [37] found from reference [27] were included in this review (Figure 1). Thirteen [4,20–23,27–30,35,36,38,39] presented original data. Seven [4,20–23,38,39] investigated the association between migraine and atrial fibrillation, four [27–30] the association between migraine after catheter ablation of atrial fibrillation and two [35,36] the association of genetic determinants for migraine with atrial fibrillation.…”

Section: Resultsmentioning

confidence: 99%

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Migraine and atrial fibrillation: a systematic review

Scutelnic

Mattle

Branca

et al. 2021

Euro J of Neurology

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Background and purpose Patients with migraine are at increased risk of stroke. The aim was to systematically review the current literature on the association between migraine and atrial fibrillation, which is a relevant risk factor for stroke. Methods PubMed was searched for ‘migraine’ AND ‘atrial fibrillation’ and selected original investigations on the association of migraine and atrial fibrillation for our analysis. Articles without original data, such as guidelines, narrative reviews, editorials and others, were excluded. Results In all, 109 publications were found. Twenty‐two were included and analysed for this review. The population‐based Atherosclerosis Risk in Communities study showed a significant association of migraine with visual aura and incident atrial fibrillation (hazard ratio 1.30, 95% confidence interval 1.03–1.62, p = 0.02), but not for migraine without aura, compared to non‐headache persons after multivariable adjustment for vascular risk factors. An even larger population‐based study in Denmark confirmed this association (odds ratio 1.25, 95% confidence interval 1.16–1.36). Studies investigating patients with ischaemic stroke and migraine are methodologically insufficient and provide contradictory results. Ablation therapy for atrial fibrillation in patients with migraine might reduce migraine attacks, but transient post‐ablation new‐onset migraine‐like headaches in persons without a history of migraine have also been reported. Conclusion Population‐based studies indicate a significant association of migraine with aura and atrial fibrillation. In practical terms, screening for atrial fibrillation in patients who have a long history of migraine might be reasonable, whereas in patients with stroke or other disorders and migraine extensive screening for atrial fibrillation should be performed as in all patients without migraine.

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Shorter visual aura characterizes young and middle-aged stroke patients with migraine with aura

et al. 2021

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Prevalence of ischemic stroke and atrial fibrillation in young patients with migraine national inpatient sample analysis

Cited by 8 publications

References 24 publications

Comorbidities of primary headache disorders: a literature review with meta-analysis

Comorbidities of primary headache disorders: a literature review with meta-analysis

Migraine and atrial fibrillation: a systematic review

Shorter visual aura characterizes young and middle-aged stroke patients with migraine with aura

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