1
|
Nathan N, Ngo A, Khoromi S. Migraine and Stroke: A Scoping Review. J Clin Med 2024; 13:5380. [PMID: 39336867 PMCID: PMC11432473 DOI: 10.3390/jcm13185380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/09/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
An increased risk of ischemic stroke in migraine with aura (MA) has been consistently demonstrated. The pathophysiology of risk factors is not yet well understood. Several mechanisms have been proposed to explain the association between MA and ischemic stroke including decreased focal cerebral blood flow and other phenomena linked with cortical spreading depression (CSD) as well as neurovascular pathology, which appear to play a key role in MA. In addition to genetic predisposition, other classic stroke risk factors such as atrial fibrillation, emboli, migraine-associated vasculopathy, endothelial dysfunction, platelet dysfunction, coagulation pathway abnormalities, and inflammatory factors have been examined and investigated. For further clarification, distinctions have been made between features of migrainous infarctions and non-migrainous infarctions among migraineurs. Furthermore, the association is less clear when considering the mixed results studying the risk of ischemic stroke in migraines without aura (MO) and the risk of hemorrhagic stroke in people with all types of migraine. Translational research is investigating the role of biomarkers which can help identify vascular links between stroke and migraine and lead to further treatment developments. We performed a scoping review of the PubMed database to further characterize and update the clinical connections between migraine and stroke.
Collapse
Affiliation(s)
| | | | - Suzan Khoromi
- Department of Neurosciences, University of California-San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA; (N.N.)
| |
Collapse
|
2
|
Osteraas ND. Sex-based difference in selected stroke etiologies: cerebral dural sinus venous thrombosis, reversible cerebral vasoconstriction syndrome, dissection, migraine, pregnancy/puerperium/OC use. J Stroke Cerebrovasc Dis 2024; 33:107753. [PMID: 38703878 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024] Open
Abstract
Females are at higher risk than males for a multitude of cerebrovascular conditions, both common and rare; partially resulting from a complex interplay between differing process involving genetics, hormonal influences, common cerebrovascular risk factors among others. Specific topics including cervical artery dissection, cerebral dural sinus venous thrombosis, reversible cerebral vasoconstriction syndrome, migraine, along with these disorders in the setting of pregnancy, puerperium and oral contraceptive utilization. Epidemiology, pathophysiology, presentation, basics of management and outcomes are presented, with sex differences throughout.
Collapse
Affiliation(s)
- Nicholas Dykman Osteraas
- Department of Neuroscience at Saint Lukes Hospital, Advocate Aurora Health. 2900 W Oklahoma Ave, Milwaukee, WI 53215, United States.
| |
Collapse
|
3
|
Tran PT, Lapeyre-Mestre M, Berangere B, Lanteri-Minet M, Palmaro A, Donnet A, Micallef J. Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events. J Headache Pain 2024; 25:68. [PMID: 38671362 PMCID: PMC11055320 DOI: 10.1186/s10194-024-01770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Several studies have focused on the use of triptan and the risk of acute vascular events but the existence of such association is still debated and has never been quantified in patients over 65 years. To assess whether triptan use among older is associated with an increased risk of hospitalization for acute vascular events. METHODS A propensity score-matched cohort study was designed using the French national health insurance database linked to hospital stays. Patients aged ≥ 65 years, newly treated by triptans between 2011 and 2014, were included… The primary event was hospitalization for an acute ischemic vascular event within de 90 days following triptan initiation. Association with triptan exposure was investigated through cox regression model, considering exposure at inclusion, and with exposure as a time-varying variable A case-crossover (CCO) and a self-controlled case series (SCCS) analyses were also conducted to address potential residual confounding. RESULTS The cohort included 24, 774 triptan users and 99 096 propensity matched controls (mean (SD) age: 71 years (5.9), 74% of women). Within 90 days after cohort entry, 163 events were observed in the triptan group, and 523 in the control group (0.66% vs. 0.53%, adjusted hazard ratio (aHR) exposed/not exposed 1.25 95%CI [1.05-1.49]; aHR time-varying 8.74 [5.21-14.66]). The association was significant (CCO) for all events (adjusted odds ratio (aOR1.63 [1.22-2.19]) with a more consistent association with cerebral events (aOR 2.14 [1.26-3.63]). The relative incidence (RI) for all events was 2.13 [1.76-2.58] in the SCCS, for cardiac (RI: 1.67 [1.23-2.27]) and for cerebral events (RI: 3.20, [2.30-4.45]). CONCLUSION The incidence of acute vascular events was low among triptan users. We found that triptan use among older may be associated with a low increased risk for acute vascular events, which may be more marked for cerebral events such as stroke, than for cardiac events.
Collapse
Affiliation(s)
- Phuong Thao Tran
- Service de Pharmacologie Médicale et Clinique, Université de Toulouse, CHU de Toulouse, Toulouse, France
- College of Pharmacy, Seoul National University, Seoul, South Korea
| | - Maryse Lapeyre-Mestre
- Service de Pharmacologie Médicale et Clinique, Université de Toulouse, CHU de Toulouse, Toulouse, France
- PEPSS "Pharmacologie En Population cohorteS et biobanqueS", Centre d'Investigation Clinique Inserm (CIC 1436), Université de Toulouse, Toulouse, France
| | - Baricault Berangere
- Service de Pharmacologie Médicale et Clinique, Université de Toulouse, CHU de Toulouse, Toulouse, France
- PEPSS "Pharmacologie En Population cohorteS et biobanqueS", Centre d'Investigation Clinique Inserm (CIC 1436), Université de Toulouse, Toulouse, France
| | - Michel Lanteri-Minet
- Neuro-Dol Inserm U1107, Université Clermont Auvergne, Clermont-Ferrand, France
- Département d'évaluation et de traitement de la douleur, CHU de Nice, FHU InovPain Université Côte Azur, Nice, France
| | - Aurore Palmaro
- Service de Pharmacologie Médicale et Clinique, Université de Toulouse, CHU de Toulouse, Toulouse, France
| | - Anne Donnet
- Neuro-Dol Inserm U1107, Université Clermont Auvergne, Clermont-Ferrand, France
- Centre d'Evaluation et de Traitement de la douleur, FHU InovPain Pôle Neurosciences Cliniques, APHM, Marseille, France
| | - Joëlle Micallef
- service de pharmacologie clinique & pharmacosurveillance, centre régional de pharmacovigilance, Aix-Marseille université, Inserm, UMR 1106, Assistance publique-Hôpitaux de Marseille, Hopital Sainte Marguerite 270, boulevard sainte Marguerite, Marseille, 13009, France.
| |
Collapse
|
4
|
Petersen CL, Hougaard A, Gaist D, Hallas J. Risk of Stroke and Myocardial Infarction Among Initiators of Triptans. JAMA Neurol 2024; 81:248-254. [PMID: 38315477 PMCID: PMC10845042 DOI: 10.1001/jamaneurol.2023.5549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 02/07/2024]
Abstract
Importance Triptans are contraindicated in patients with ischemic heart disease or previous myocardial infarction, and caution is advised when prescribing these drugs to patients with vascular risk factors. However, controlled observational studies have either shown no association or an apparent lower risk, possibly owing to a channeling of triptans to individuals at low risk of cardiovascular outcomes, and it remains unclear whether avoiding triptan treatment for these patients is meaningful. Objective To establish whether an association between triptans and ischemic events could be demonstrated using a self-controlled design because this type of design is robust to the previously mentioned type of confounding. Design, Setting, and Participants All people in nationwide Danish registries who were initiating triptans and all the ischemic events that they experienced were identified. A case-crossover design was used to estimate odds ratios (OR) for associations between first-ever triptan use and ischemic outcomes, comparing triptan exposure in the 2-week period up to the event with four 2-week reference periods. Data were obtained for the period January 1995 to August 2022. Included from the population of Denmark were individuals redeeming a prescription for any triptan and experiencing at least 1 of 3 predefined ischemic outcomes. No one was excluded. Exposure Initiation of any triptan. Main Outcomes and Measures Acute myocardial infarction, ischemic stroke, or nonspecified stroke. Results Identified were a total of 429 612 individuals (median [IQR] age, 38 [28-48] years; 325 687 female [75.8%]) who redeemed a first prescription for a triptan in the study period. Of these patients, 11 (0.003%) had a myocardial infarction with the first triptan prescription in either a focal or referent window (odds ratio [OR], 3.3; 95% CI, 1.0-10.9), 18 (0.004%) had ischemic stroke (OR, 3.2; 95% CI, 1.3-8.1), and 35 (0.008%) had ischemic/nonspecified stroke (OR, 3.0; 95% CI, 1.5-5.9). Case patients had a median age of approximately 60 years and had a high-risk cardiovascular profile. Conclusions and Relevance Results of this case-crossover study suggest that triptan initiation was associated with higher risk of ischemic stroke and myocardial infarction. For the individual patient with low background cardiovascular risk, the risk of an ischemic event after triptan initiation was very low.
Collapse
Affiliation(s)
- Christian Lund Petersen
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
- Department of Radiology, University Hospital of Southern Denmark, Odense, Denmark
| | - Anders Hougaard
- Department of Neurology, Copenhagen University Hospital—Herlev, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - David Gaist
- Research Unit for Neurology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Jesper Hallas
- Department of Clinical Pharmacology, Odense University Hospital, Odense, Denmark
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
5
|
Zhang L, Zhang H, Zhou X, Zhao J, Wang X. Bibliometric Analysis of Research on Migraine-Stroke Association from 2013 to 2023. J Pain Res 2023; 16:4089-4112. [PMID: 38058980 PMCID: PMC10697147 DOI: 10.2147/jpr.s438745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/22/2023] [Indexed: 12/08/2023] Open
Abstract
Background Both migraine and stroke heavily burden individuals, health systems, and society. The migraine-stroke association is of concern and has been studied widely. Our objective is to explore and overview the current research status and emerging trends. Materials and Methods Studies on migraine-stroke association from January 2013 to May 2023 were retrieved and screened from the Web of Science Core Collection (WOSCC) database. Records fulfilling the selection criteria were downloaded and imported into CiteSpace for data mining and visualization. Results A total of 862 papers on migraine-stroke association were included. Annual publications grew slowly. The United States and European countries dominated research in this area. Harvard University published the largest number of articles, while the University of London was most active with other institutions. Ayata Cenk contributed the most articles, while KURTH T and NEUROLOGY were co-cited most. Research hotspots included migraine with aura, ischemic stroke, patent foramen ovale, cortical spreading depolarization, meta-analysis, cross-sectional study, and risk factors. Pathophysiology and small vessel disease represented research frontiers and emerging trends. Conclusion Our study scientifically outlines the migraine-stroke association over the past decade, presenting useful information.
Collapse
Affiliation(s)
- Long Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
- Department of Traditional Chinese Medicine, Zibo TCM-Integrated Hospital, Zibo, Shandong, People’s Republic of China
| | - Hongyan Zhang
- Department of Traditional Chinese Medicine, Shanghai Sixth People’s Hospital, Shanghai, People’s Republic of China
- Shaanxi Key Laboratory of Research on TCM Physical Constitution and Diseases Prevention and Treatment, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People’s Republic of China
| | - Xue Zhou
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
| | - Jing Zhao
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
| | - Xingchen Wang
- Division of Neurology, the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China
| |
Collapse
|
6
|
Feng S, Yang M, Liu S, He Y, Deng S, Gong Y. Oxidative stress as a bridge between age and stroke: A narrative review. JOURNAL OF INTENSIVE MEDICINE 2023; 3:313-319. [PMID: 38028635 PMCID: PMC10658045 DOI: 10.1016/j.jointm.2023.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/09/2022] [Accepted: 02/07/2023] [Indexed: 12/01/2023]
Abstract
Stroke is the third most common cause of death globally and a leading cause of disability. The cellular and molecular changes following stroke and causes of neuronal death are not fully understood, and there are few effective treatments currently available. A rapid increase in the levels of reactive oxygen species (ROS) post stroke can overwhelm antioxidant defenses and trigger a series of pathophysiologic events including the inflammatory response, blood-brain barrier (BBB) disruption, apoptosis, and autophagy, ultimately leading to neuron degeneration and apoptosis. It is thought that beyond a certain age, the ROS accumulation resulting from stroke increases the risk of morbidity and mortality. In the present review, we summarize the role of oxidative stress (OS) as a link between aging and stroke pathogenesis. We also discuss how antioxidants can play a beneficial role in the prevention and treatment of stroke by eliminating harmful ROS, delaying aging, and alleviating damage to neurons.
Collapse
Affiliation(s)
- Shengjie Feng
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Miaoxian Yang
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shengpeng Liu
- Department of Pediatrics, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, 518020,China
| | - Yu He
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Shuixiang Deng
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ye Gong
- Department of Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| |
Collapse
|
7
|
Miglani A, Germroth M, LaPointe KA, Nguyen SA, Meyer TA. Treatment of sinus headache using a device that combines acoustic vibration with oscillating expiratory pressure. Laryngoscope Investig Otolaryngol 2023; 8:839-846. [PMID: 37621300 PMCID: PMC10446260 DOI: 10.1002/lio2.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/06/2023] [Accepted: 07/16/2023] [Indexed: 08/26/2023] Open
Abstract
Objective To determine if simultaneous administration of acoustic vibration and oscillating expiratory pressure affects the severity of facial pain among patients with complaint of "sinus headache". Methods This is a prospective single-arm observational study performed at a tertiary care medical center. Subjects with complaint of sinus headache without evidence of chronic rhinosinusitis on exam or computed tomography participated in a clinical study applying simultaneous acoustic vibrations and positive expiratory pressure to the nasal cavity twice daily over 4 weeks. Efficacy was assessed using three validated pain metrics-pain visual analog scale (VAS), brief pain inventory-short form (BPI-SF), and McGill pain questionnaire-short form (MPQ-SF). Device safety and patient satisfaction were also assessed using questionnaires. Results Twenty-nine patients (mean age 49 years, 55% female) completed the study without any major adverse events. At the 4 week follow-up, facial pain VAS improved from mean ± SD of 59.6 ± 15.7 to 34.6 ± 21.7 (p < .001), BPI mean pain (mean ± standard deviation) improved from 4.4 ± 2.0 to 2.9 ± 1.9 (p = .007), and MPQ-SF total improved from 12.2 ± 6.5 to 6.5 ± 5.2 (p < .001) with approximately 70% of patients achieving a minimal clinically important difference (MCID) across all metrics. Additionally, pain VAS was assessed 5 min after a single use at baseline with significant improvement (p < .001). Eighty-six percent of subjects would both use device again and recommend it to others. Conclusions Simultaneous administration of acoustic vibration and oscillating expiratory pressure appears to be a safe treatment for sinus headaches in patients without objective evidence of chronic sinusitis. Results from this initial study are promising with regard to efficacy in treatment of sinus headaches but will require further study. Level of evidence 2c.
Collapse
Affiliation(s)
- Amar Miglani
- Department of Otolaryngology‐Head & Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
- Division of Rhinology and Skull Base Surgery, Department of Otolaryngology‐Head & Neck SurgeryMayo ClinicPhoenixArizonaUSA
| | - Matthew Germroth
- Department of Otolaryngology‐Head & Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Kristina A. LaPointe
- Department of Otolaryngology‐Head & Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Shaun A. Nguyen
- Department of Otolaryngology‐Head & Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Ted A. Meyer
- Department of Otolaryngology‐Head & Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| |
Collapse
|
8
|
Marusich T, Solodovnikova Y, Hnatyuk I, Son A. Hemorrhagic stroke as a rare complication of a migraine without aura. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00600-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Migraine is a chronic neurological disorder, characterized by recurrent headache attacks featuring specific clinical characteristics. Two-thirds of the migraineurs are women. It takes the second place among the world’s causes of disability, and is one of the leading causes for direct and indirect government expenses. Migraine is well known to be associated with cerebrovascular diseases, in particular with stroke. Due to the recent studies, the risk of hemorrhagic stroke (HS) is 50% higher in between migraineurs in comparison to non-migraineurs, whereas only one study showed association of migraine without aura (MwtA) with increased HS incidence.
Case presentation
We present a case of 57-year-old White woman, who is a 20-year migraine sufferer admitted to the hospital with the signs of migraineous stroke. Upon evaluation after she had contrast enhancing brain magnetic resonance imaging (MRI), she was diagnosed with a neoplasm accompanied by a hemorrhage. However, the following magnetic resonance spectroscopy (MRS) as well as repeated contrast MRI did not prove the diagnosis. The patient was treated for 10 days, and discharged with complete clinical improvement.
Conclusion
The presented case highlights the importance of the accurate evaluation of the patients, suspicious of complicated migraine, even though suffering from MwtA, having no comorbidities and absent family history of cerebrovascular diseases.
Collapse
|
9
|
Konstantinos F, Tsolaki V, Georgakopoulou VE, Aravantinou A, Fotakopoulos G. Value of Combination Therapy With Antiepileptic Drugs (AEDs) for Migraine to Prevent Ischemic Stroke in Young Women. Cureus 2022; 14:e26972. [PMID: 36000114 PMCID: PMC9389468 DOI: 10.7759/cureus.26972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2022] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to systematically assess the efficacy of a combination of levetiracetam and sumatriptan as a preventive treatment for migraine and stroke in young women. This was a retrospective study with 342 female patients, who experienced migraines. All patients were divided into three groups: Group A (124 patients (36.2%) with triptan (sumatriptan) monotherapy), Group B (111 patients (32.4%) with a combined triptan and antiepileptic drug (AED) therapy with levetiracetam (LEV)), and Group C (107 (31.2%) patients with placebo treatment), in a 1.4:1.1:1 ratio respectively. Significant differences were found in Group B when compared with Groups A and C with respect to the use of combination hormonal contraception, smoking, a family history of migraine, and seizures. The results of this study suggested that combination treatment with levetiracetam and sumatriptan was more effective in preventing migraines and reducing the risk of stroke in young women than sumatriptan monotherapy.
Collapse
|
10
|
Pero A, Pace A, Dhamoon MS. Triptan medication use among patients with migraine with contraindications in the US. Headache 2022; 62:883-889. [DOI: 10.1111/head.14327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Adriana Pero
- Icahn School of Medicine at Mount Sinai New York New York USA
| | - Anna Pace
- Department of Neurology Icahn School of Medicine at Mount Sinai New York New York USA
| | - Mandip S. Dhamoon
- Department of Neurology Icahn School of Medicine at Mount Sinai New York New York USA
| |
Collapse
|
11
|
Olsen TS, Andersen KK. Absolute risk of ischemic and hemorrhagic stroke in Danish women using oral contraceptives. Acta Neurol Scand 2022; 145:565-570. [PMID: 35089604 DOI: 10.1111/ane.13584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Uncertainty exists for the absolute risk of ischemic and hemorrhagic stroke in users of oral contraceptives (OCs). Estimates greatly vary between countries. In Denmark, absolute risk of ischemic stroke (IS) is estimated to be 21 per 100,000 person-years. Risk of cerebral hemorrhage (CH) is unknown. Using the Danish Stroke Registry, we investigated absolute risk of IS and CH in users of OC. MATERIAL AND METHODS For the Danish female population aged 15-49 years during 2003-2011, we obtained information on hospital admission for IS and CH and current use of OC from Danish nationwide registries. We defined current use of OC as redeeming at least two OC prescriptions within the previous year. RESULTS The Danish female population years 2003-2011 consisted mean of 1,246,142 women per year. Of these, 29.6% were OC users. In the study period, OC users had 291 IS and 14 CH. Absolute risk of IS in OC users was 8.8 per 100,000 person-years and of CH it was 0.4 per 100,000 person-years. CONCLUSIONS In OC users, absolute risk of IS was 8.8 per 100,000 person-years. This is more than half that of the risk previously assumed in Denmark. Risk of CH in OC users was very low and 0.4 per 100,000 person-years.
Collapse
Affiliation(s)
- Tom Skyhøj Olsen
- Department of Neurology Bispebjerg University Hospital Copenhagen Denmark
| | - Klaus Kaae Andersen
- Section of Statistics Danish Cancer Society Research Center Copenhagen Denmark
| |
Collapse
|
12
|
Myocardial infarction in a patient with migraine and triptan overuse treated with anti-CGRP receptor monoclonal antibody: a case report. J Neurol 2022; 269:5170-5172. [PMID: 35420352 DOI: 10.1007/s00415-022-11128-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 10/18/2022]
|
13
|
Migraine and Stroke. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
14
|
Delva II. MIGRAINE AND CEREBROVASCULAR DISEASES. BULLETIN OF PROBLEMS BIOLOGY AND MEDICINE 2022. [DOI: 10.29254/2077-4214-2022-4-167-44-48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
15
|
McKinley EC, Lay CL, Rosenson RS, Chen L, Chia V, Colantonio LD, Muntner P, Urman R, Farkouh ME. Risk for ischemic stroke and coronary heart disease associated with migraine and migraine medication among older adults. J Headache Pain 2021; 22:124. [PMID: 34645382 PMCID: PMC8513203 DOI: 10.1186/s10194-021-01338-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/01/2021] [Indexed: 12/31/2022] Open
Abstract
Background Migraine has been associated with cardiovascular disease (CVD) events among middle-aged adults. The objective of this study was to determine the risk for ischemic stroke and coronary heart disease (CHD) events among older adults with versus without migraine. Methods This retrospective cohort study was conducted using data from US adults ≥66 years of age with Medicare health insurance between 2008 and 2017. After stratification by history of CVD, patients with a history of migraine were matched 1:4 to those without a history of migraine, based on calendar year, age, and sex. Patients were followed through December 31, 2017 for ischemic stroke and CHD events including myocardial infarction or coronary revascularization. All analyses were done separately for patients with and without a history of CVD. Results Among patients without a history of CVD (n = 109,950 including n = 21,990 with migraine and n = 87,960 without migraine), 1789 had an ischemic stroke and 3552 had a CHD event. The adjusted hazard ratio (HR) among patients with versus without migraine was 1.20 (95% confidence interval [95%CI], 1.07–1.35) for ischemic stroke and 1.02 (95%CI, 0.93–1.11) for CHD events. Compared to patients without migraine, those with migraine who were taking an opioid medication had a higher risk for ischemic stroke (adjusted HR 1.43 [95%CI, 1.20–1.69]), while those taking a triptan had a lower risk for CHD events (adjusted HR 0.79 [95%CI, 0.67–0.93]). Among patients with a history of CVD (n = 79,515 including n = 15,903 with migraine and n = 63,612 without migraine), 2960 had an ischemic stroke and 7981 had a CHD event. The adjusted HRs (95%CI) for ischemic stroke and CHD events associated with migraine were 1.27 (1.17–1.39) and 0.99 (0.93–1.05), respectively. Patients with migraine taking an opioid medication had a higher risk for ischemic stroke (adjusted HR 1.21 [95%CI, 1.07–1.36]), while those taking a triptan had a lower risk for CHD events (adjusted HR 0.83 [95%CI, 0.72–0.95]), each versus those without migraine. Conclusions Older adults with migraine are at increased risk for ischemic stroke. The risk for ischemic stroke among older adults with migraine may differ by migraine medication classes. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-021-01338-z.
Collapse
Affiliation(s)
- Emily C McKinley
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd, RPHB 523B, Birmingham, AL, 35233-0013, USA.
| | - Christine L Lay
- Centre for Headache, University of Toronto, Toronto, ON, Canada
| | | | - Ligong Chen
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd, RPHB 523B, Birmingham, AL, 35233-0013, USA
| | | | - Lisandro D Colantonio
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd, RPHB 523B, Birmingham, AL, 35233-0013, USA
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Blvd, RPHB 523B, Birmingham, AL, 35233-0013, USA
| | | | - Michael E Farkouh
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Canada
| |
Collapse
|
16
|
Øie LR, Kurth T, Gulati S, Dodick DW. Migraine and risk of stroke. J Neurol Neurosurg Psychiatry 2020; 91:593-604. [PMID: 32217787 PMCID: PMC7279194 DOI: 10.1136/jnnp-2018-318254] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 12/31/2022]
Abstract
Migraine and stroke are two common and heterogeneous neurovascular disorders responsible for a significant burden for those affected and a great economic cost for the society. There is growing evidence that migraine increases the overall risk of cerebrovascular diseases. In this review, based on available literature through a PubMed search, we found that ischaemic stroke in people with migraine is strongly associated with migraine with aura, young age, female sex, use of oral contraceptives and smoking habits. The risk of transient ischaemic attack also seems to be increased in people with migraine, although this issue has not been extensively investigated. Although migraine appears to be associated with haemorrhagic stroke, the migraine aura status has a small influence on this relationship. Neuroimaging studies have revealed a higher prevalence of asymptomatic structural brain lesions in people with migraine. They are also more likely to have unfavourable vascular risk factors; however, the increased risk of stroke seems to be more apparent among people with migraine without traditional risk factors. The mechanism behind the migraine-stroke association is unknown. In light of the higher risk of stroke in people with migraine with aura, it is important to identify and modify any vascular risk factor. There is currently no direct evidence to support that a migraine prophylactic treatment can reduce future stroke in people with migraine.
Collapse
Affiliation(s)
- Lise R Øie
- Department of Neurology, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway .,Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sasha Gulati
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.,Department of Neurosurgery, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - David W Dodick
- Department of Neurology, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA
| |
Collapse
|
17
|
Petersen TG, Liew Z, Andersen AMN, Andersen GL, Andersen PK, Martinussen T, Olsen J, Rebordosa C, Tollånes MC, Uldall P, Wilcox AJ, Strandberg-Larsen K. Use of paracetamol, ibuprofen or aspirin in pregnancy and risk of cerebral palsy in the child. Int J Epidemiol 2019; 47:121-130. [PMID: 29149272 DOI: 10.1093/ije/dyx235] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 01/28/2023] Open
Abstract
Background It has been debated whether mild analgesics, mainly paracetamol, adversely affect aspects of neurodevelopment. We examined whether mother's use of paracetamol, aspirin or ibuprofen in pregnancy is associated with increased risk of cerebral palsy (CP) in the child. Method We included 185 617 mother-child pairs from the Danish National Birth Cohort and the Norwegian Mother and Child Cohort Study. We created harmonized definitions of analgesic use in pregnancy, as well as indications for analgesic use and other potential confounders. Children with CP were identified in nationwide registers. We estimated the average causal effect of analgesics on risk of CP using marginal structural models with stabilized inverse probability weights. Results Paracetamol use was reported in 49% of all pregnancies, aspirin in 3% and ibuprofen in 4%. Prenatal exposure to paracetamol ever in pregnancy was associated with increased risk of overall CP [adjusted odds ratio (aOR) 1.3, 95% confidence interval (CI): 1.0-1.7] and unilateral spastic CP (aOR 1.5, 95% CI: 1.0-2.2). The association appeared to be driven by an increased risk of unilateral spastic CP in children exposed in second trimester (aOR 1.6, 95% CI: 1.0-2.5). Children ever prenatally exposed to aspirin in pregnancy had an elevated risk of bilateral spastic CP (aOR 2.4, 95% CI: 1.1-5.3) compared with unexposed. Conclusion We observed an increased risk of spastic CP in children prenatally exposed to paracetamol and aspirin. Although we controlled for several important indications for analgesic use, we cannot exclude the possibility of confounding by underlying diseases.
Collapse
Affiliation(s)
- Tanja Gram Petersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Guro L Andersen
- Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Martinussen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Cristina Rebordosa
- Pharmacoepidemiology and Risk Management, Research Triangle Institute Health Solutions, Barcelona, Spain
| | | | - Peter Uldall
- Pediatric Department, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Allen J Wilcox
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Katrine Strandberg-Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
18
|
Yilmaz Avci A, Akkucuk MH, Torun E, Arikan S, Can U, Tekindal MA. Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study. Neurol Sci 2019; 40:703-711. [DOI: 10.1007/s10072-019-3710-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 01/08/2019] [Indexed: 01/03/2023]
|
19
|
Sacco S, Merki-Feld GS, Ægidius KL, Bitzer J, Canonico M, Kurth T, Lampl C, Lidegaard Ø, Anne MacGregor E, MaassenVanDenBrink A, Mitsikostas DD, Nappi RE, Ntaios G, Sandset PM, Martelletti P. Hormonal contraceptives and risk of ischemic stroke in women with migraine: a consensus statement from the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESC). J Headache Pain 2017; 18:108. [PMID: 29086160 PMCID: PMC5662520 DOI: 10.1186/s10194-017-0815-1] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/09/2017] [Indexed: 12/18/2022] Open
Abstract
Several data indicate that migraine, especially migraine with aura, is associated with an increased risk of ischemic stroke and other vascular events. Of concern is whether the risk of ischemic stroke in migraineurs is magnified by the use of hormonal contraceptives. As migraine prevalence is high in women of reproductive age, it is common to face the issue of migraine and hormonal contraceptive use in clinical practice. In this document, we systematically reviewed data about the association between migraine, ischemic stroke and hormonal contraceptive use. Thereafter a consensus procedure among international experts was done to develop statements to support clinical decision making, in terms of cardiovascular safety, for prescription of hormonal contraceptives to women with migraine. Overall, quality of current evidence regarding the risk of ischemic stroke in migraineurs associated with the use of hormonal contraceptives is low. Available data suggest that combined hormonal contraceptive may further increase the risk of ischemic stroke in those who have migraine, specifically migraine with aura. Thus, our current statements privilege safety and provide several suggestions to try to avoid possible risks. As the quality of available data is poor further research is needed on this topic to increase safe use of hormonal contraceptives in women with migraine.
Collapse
Affiliation(s)
- Simona Sacco
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
| | - Gabriele S Merki-Feld
- Department of Gynecology, Clinic for Reproductive Endocrinology, University Hospital, Zürich, Switzerland
| | - Karen Lehrmann Ægidius
- Department of Neurology, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | - Marianne Canonico
- Université Paris-Saclay, University Paris-Sud, UVSQ, CESP, Inserm UMRS1018, Orsay, France
| | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Lampl
- Headache Medical Center Seilerstaette Linz, Linz, Austria.,Department of Geriatric Medicine Ordensklinikum Linz, Linz, Austria
| | - Øjvind Lidegaard
- Department of Obstetrics & Gynaecology, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - E Anne MacGregor
- Centre for Neuroscience & Trauma, BICMS, Barts and the London School of Medicine and Dentistry, London, UK.,Barts Sexual Health Centre, St Bartholomew's Hospital, London, UK
| | - Antoinette MaassenVanDenBrink
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dimos-Dimitrios Mitsikostas
- Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Rossella Elena Nappi
- Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,University Consortium for Adaptive Disorders and Head Pain (UCADH), University of Pavia, Pavia, Italy
| | - George Ntaios
- Department of Medicine, University of Thessaly, Larissa, Greece
| | - Per Morten Sandset
- Department of Haematology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | | |
Collapse
|
20
|
Osler M, Wium-Andersen IK, Jørgensen MB, Jørgensen TSH, Wium-Andersen MK. Migraine and risk of stroke and acute coronary syndrome in two case-control studies in the Danish population. Clin Epidemiol 2017; 9:439-449. [PMID: 28919819 PMCID: PMC5587091 DOI: 10.2147/clep.s144441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Migraine has consistently been associated with increased risk of ischemic stroke, while the evidence for a relation with other types of stroke or coronary outcomes is limited. We examined the association between migraine and stroke and acute coronary syndrome (ACS) subtypes and the influence of potential confounding factors. METHODS All first-time hospital contacts for stroke (n=155,216) or ACS (n=97,799) were identified in Danish National Patient Registers and matched with 2 control groups of the background population. A hospital diagnosis of migraine and use of migraine medication were the main exposures and associations (odds ratios [OR]) were estimated using multiple logistic regression. Confounding was also addressed by including use of general headache medication as a negative control exposure. RESULTS The diagnosis of migraine was associated with increased odds of both stroke (ORcrude, age <50 years: 4.80 [95% CI: 3.75-6.21]; ORcrude, age ≥50 years:1.91 [95% CI: 1.67-2.19]) and ACS (ORcrude:1.88 [95% CI: 1.53-2.32]), while the ORs for the associations between migraine medication and stroke and ACS were lower. Patients with a diagnosis of migraine or redeemed migraine medication had increased ORs of all stroke subtypes (ischemic, hemorrhagic stroke and transient ischemic attacks). The diagnosis of migraine was also associated with both angina and myocardial infarction (ST-elevation Myocardial Infarction [STEMI], non-STEMI and unspecified) with the highest OR for angina. These associations were not fully explained by adjustment for confounding co-variables or when compared with the negative control exposure that were assumed to be influenced by similar confounding factors, but no shared pathogenesis. CONCLUSION Hospital-diagnosed migraine was associated with all stroke and ACS subtypes, with ischemic stroke and angina having the highest odds. Confounding did not explain the associations.
Collapse
Affiliation(s)
- Merete Osler
- Research Center for Prevention and Health, Rigshospitalet – Glostrup, Copenhagen University, Glostrup, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen
| | - Ida Kim Wium-Andersen
- Research Center for Prevention and Health, Rigshospitalet – Glostrup, Copenhagen University, Glostrup, Denmark
- Department of Psychiatry O, Rigshospitalet, Copenhagen, Denmark
| | | | - Terese Sara Høj Jørgensen
- Research Center for Prevention and Health, Rigshospitalet – Glostrup, Copenhagen University, Glostrup, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen
| | - Marie Kim Wium-Andersen
- Research Center for Prevention and Health, Rigshospitalet – Glostrup, Copenhagen University, Glostrup, Denmark
| |
Collapse
|
21
|
Raschi E, Poluzzi E, De Ponti F. Stroke, Migraine and Triptans: From Bedside to Bench. EBioMedicine 2016; 6:14-15. [PMID: 27211537 PMCID: PMC4856773 DOI: 10.1016/j.ebiom.2016.03.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Emanuel Raschi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Elisabetta Poluzzi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Fabrizio De Ponti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|