Migraine Headache and Long-Term Cardiovascular Outcomes: An Extended Follow-Up of the Women's Ischemia Syndrome Evaluation - 27/09/17
, Islam Y. Elgendy, MD b, B. Delia Johnson, PhD c, Steven E. Reis, MD d, Diane V. Thompson, MS e, Barry L. Sharaf, MD f, Vera Bittner, MD g, George Sopko, MD h, C. Noel Bairey Merz, MD i, Carl J. Pepine, MD b, Bina Ahmed, MD jAbstract |
Background |
The association between migraine headache and cardiovascular events has been inconsistent. This study determines the long-term risk of cardiovascular events among women with and without a history of migraine headache who were under evaluation for suspected myocardial ischemia in the Women's Ischemia Syndrome Evaluation (WISE).
Methods |
The WISE is a National Heart, Lung and Blood Institute-sponsored prospective, multicenter study that aims to improve myocardial ischemia evaluation in women. A total of 936 women presenting with symptoms of myocardial ischemia underwent structured data collection and coronary angiography. Information pertaining to migraine headache was available in 917 women. All-cause mortality data were available on all women for a median of 9.5 years, and nonfatal cardiovascular event data were available on 888 women for a median of 6.5 years.
Results |
A total of 224 (24.4%) women reported a history of migraine headache. Compared with women who did not report a history of migraine headache, women with a history of migraine headache had an increased adjusted risk of cardiovascular event (cardiovascular death, nonfatal myocardial infarction, heart failure, or stroke) (hazard ratio 1.83; 95% confidence interval, 1.22-2.75) at a median follow-up of 6.5 years. This result was driven mainly by a twofold increase in the risk of stroke (hazard ratio 2.33; 95% confidence interval, 1.16-4.68).
Conclusion |
Among women being evaluated for ischemic heart disease, those reporting a history of migraine headache had increased risk of future cardiovascular events on long-term follow-up. This risk was primarily driven by a more-than twofold increase in the risk of stroke.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiovascular disease, Migraine, Mortality, Stroke, Women
Plan
| Funding: This work was supported by contracts from the National Heart, Lung and Blood Institutes nos. N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164, grants U0164829, U01 HL649141, U01 HL649241, K23HL105787, T32HL69751, R01 HL090957, 1R03AG032631 from the National Institute on Aging, GCRC grant MO1-RR00425 from the National Center for Research Resources, the National Center for Advancing Translational Sciences Grant UL1TR000124, and grants from the Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ, The Women's Guild of Cedars-Sinai Medical Center, Los Angeles, CA, The Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA, QMED, Inc, Laurence Harbor, NJ, the Edythe L. Broad and the Constance Austin Women's Heart Research Fellowships, Cedars-Sinai Medical Center, Los Angeles, California, the Barbra Streisand Women's Cardiovascular Research and Education Program, Cedars-Sinai Medical Center, Los Angeles, The Society for Women's Health Research (SWHR), Washington, DC, The Linda Joy Pollin Women's Heart Health Program, and the Erika Glazer Women's Heart Health Project, and the Adelson Family Foundation, Cedars-Sinai Medical Center, Los Angeles, Calif. |
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| Conflict of Interest: The following authors report that they have no conflicts of interest related to the content of this manuscript: CAR, IYE, BDJ, SER, DVT, BLS, GS, BA. VB reports that she serves on the steering committees for ODYSSEY (Sanofi/Regeneron) and PCSK9 inhibitor trial (Eli Lilly); is an investigator for Pharmacoepidemiology (Amgen); National Coordinator for DalGene (DalCor) and STREMGTH (Astra-Zeneca); site PI for ARTEMIS (Astra-Zeneca) and COMPASS (Bayer); and participates in TNT-related manuscripts (Pfizer), grant proposal review (PackHealth), and the CVD Question Writing Committee for ABIM. CNBM reports the following: Lectures, paid to Cedars Sinai Medical Center (CSMC); Beaumont 7th Annual Heart Disease; C3; European Horizon 2020; Florida Hospital; INOVA; Korean Cardiology Society; 5th Annual Flagstaff Cardiology Symposium; PCP Symposium – Santa Rosa; Practice Point Communication; Pri-Med; Valley Health Grand Rounds; VBWG; University of Colorado; University of Utah; Washington University Grand Rounds; WomenHeart. Consulting, paid to CSMC: Gilead and Medscape. Lectures, paid to CNBM; NIH-CASE grant review study section; Research Triangle Institute (RTI) International. Research funding: WISE HFpEF, RWISE, Microvascular, Normal Control (Cedars); FAMRI (Flight Attendant Medical Research Institute). CJP received funding from grants from the National Institutes of Health-National Heart, Lung, and Blood Institute during the conduct of the study (WISE); unrestricted educational grants to the University of Florida for the Vascular Biology Working Group – Significant: Amarin, AstraZeneca, Baxter, Boehringer Ingelheim, Caladasis, Daiichi Sankyo, Genentech, Sanofi/Aventis; Modest: Amgen, Cytori, Esperion, Gilead, ISIS Pharmaceuticals, Mesoblast, Neostem, Unified Therapeutics. |
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| Authorship: All authors had access to the data and a role in writing the manuscript. This work is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or National Institutes of Health. |
Vol 130 - N° 6
P. 738-743 - juin 2017 Retour au numéro
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