X Michelle Androulakis1, Nishanth Kodumuri1, Lauren D Giamberardino1, Wayne D Rosamond1, Rebecca F Gottesman1, Eunsil Yim1, Souvik Sen2. 1. From the Department of Neurology (X.M.A., N.K., L.D.G., S.S.), University of South Carolina, School of Medicine, Columbia; Department of Epidemiology (W.D.R., E.Y.), Gillings School of Public Health, University of North Carolina, Chapel Hill; and Department of Neurology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD. 2. From the Department of Neurology (X.M.A., N.K., L.D.G., S.S.), University of South Carolina, School of Medicine, Columbia; Department of Epidemiology (W.D.R., E.Y.), Gillings School of Public Health, University of North Carolina, Chapel Hill; and Department of Neurology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD. Souvik.Sen@uscmed.sc.edu.
Abstract
OBJECTIVE: To investigate the association among migraine, ischemic stroke, and stroke subtypes in the Atherosclerosis Risk in Communities (ARIC) study. METHODS: In this ongoing, prospective, longitudinal community-based cohort study, participants were given an interview ascertaining migraine history in 1993-1995, and were followed for all vascular events, including stroke. All stroke events over the subsequent 20 years were adjudicated and classified into stroke subtypes by standard definitions. Cox proportional hazards models adjusted for stroke risk factors were used to study the relationship between migraine and ischemic stroke, overall, as well as stroke subtypes (cardioembolic, lacunar, or thrombotic). RESULTS: We identified 1,622 migraineurs among 12,758 participants. Mean age of the study population at the 3rd clinical visit was 59 years. When compared to nonheadache participants, there was a significant association between migraine with visual aura and ischemic stroke (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.2-2.6, p = 0.008). Migraine without visual aura was not significantly associated with ischemic stroke (HR 1.2, CI 1.0-1.8, p = 0.28) when compared to nonheadache participants. Among the 3 subtypes of ischemic stroke evaluated, migraine with visual aura was significantly associated only with cardioembolic stroke (HR 3.7, 95% CI 1.6-8.7, p = 0.003). CONCLUSION: In participants with migraine with visual aura in late middle age, increased risk of cardioembolic stroke was observed. Migraine with visual aura was linked to increased stroke risk, while migraine without visual aura was not, over the period of 20 years. These results are specific to older migraineurs.
OBJECTIVE: To investigate the association among migraine, ischemic stroke, and stroke subtypes in the Atherosclerosis Risk in Communities (ARIC) study. METHODS: In this ongoing, prospective, longitudinal community-based cohort study, participants were given an interview ascertaining migraine history in 1993-1995, and were followed for all vascular events, including stroke. All stroke events over the subsequent 20 years were adjudicated and classified into stroke subtypes by standard definitions. Cox proportional hazards models adjusted for stroke risk factors were used to study the relationship between migraine and ischemic stroke, overall, as well as stroke subtypes (cardioembolic, lacunar, or thrombotic). RESULTS: We identified 1,622 migraineurs among 12,758 participants. Mean age of the study population at the 3rd clinical visit was 59 years. When compared to nonheadache participants, there was a significant association between migraine with visual aura and ischemic stroke (hazard ratio [HR] 1.7, 95% confidence interval [CI] 1.2-2.6, p = 0.008). Migraine without visual aura was not significantly associated with ischemic stroke (HR 1.2, CI 1.0-1.8, p = 0.28) when compared to nonheadache participants. Among the 3 subtypes of ischemic stroke evaluated, migraine with visual aura was significantly associated only with cardioembolic stroke (HR 3.7, 95% CI 1.6-8.7, p = 0.003). CONCLUSION: In participants with migraine with visual aura in late middle age, increased risk of cardioembolic stroke was observed. Migraine with visual aura was linked to increased stroke risk, while migraine without visual aura was not, over the period of 20 years. These results are specific to older migraineurs.
Authors: W D Rosamond; A R Folsom; L E Chambless; C H Wang; P G McGovern; G Howard; L S Copper; E Shahar Journal: Stroke Date: 1999-04 Impact factor: 7.914
Authors: Christine S Autenrieth; Kelly R Evenson; Hiroshi Yatsuya; Eyal Shahar; Christopher Baggett; Wayne D Rosamond Journal: Neuroepidemiology Date: 2012-10-24 Impact factor: 3.282
Authors: V Gallai; P Sarchielli; C Firenze; A Trequattrini; M Paciaroni; F Usai; R Palumbo Journal: Acta Neurol Scand Date: 1994-01 Impact factor: 3.209
Authors: Mark C Kruit; Mark A van Buchem; Paul A M Hofman; Jacobus T N Bakkers; Gisela M Terwindt; Michel D Ferrari; Lenore J Launer Journal: JAMA Date: 2004-01-28 Impact factor: 56.272
Authors: Souvik Sen; Kolby Redd; Tushar Trivedi; Kevin Moss; Alvaro Alonso; Elsayed Z Soliman; Jared W Magnani; Lin Y Chen; Rebecca F Gottesman; Wayne Rosamond; James Beck; Stephen Offenbacher Journal: Am Heart J Date: 2021-01-24 Impact factor: 4.749
Authors: Mauro F F Mediano; Yejin Mok; Josef Coresh; Anna Kucharska-Newton; Priya Palta; Kamakshi Lakshminarayan; Wayne D Rosamond; Kunihiro Matsushita; Silvia Koton Journal: Stroke Date: 2021-03-31 Impact factor: 10.170
Authors: Simona Sacco; Gabriele S Merki-Feld; Karen Lehrmann Ægidius; Johannes Bitzer; Marianne Canonico; Tobias Kurth; Christian Lampl; Øjvind Lidegaard; E Anne MacGregor; Antoinette MaassenVanDenBrink; Dimos-Dimitrios Mitsikostas; Rossella Elena Nappi; George Ntaios; Per Morten Sandset; Paolo Martelletti Journal: J Headache Pain Date: 2017-10-30 Impact factor: 7.277
Authors: Ahmed N Mahmoud; Amgad Mentias; Akram Y Elgendy; Abdul Qazi; Amr F Barakat; Marwan Saad; Ala Mohsen; Ahmed Abuzaid; Hend Mansoor; Mohammad K Mojadidi; Islam Y Elgendy Journal: BMJ Open Date: 2018-03-27 Impact factor: 2.692
Authors: Souvik Sen; X Michelle Androulakis; Viktoriya Duda; Alvaro Alonso; Lin Yee Chen; Elsayed Z Soliman; Jared Magnani; Tushar Trivedi; Anwar T Merchant; Rebecca F Gottesman; Wayne D Rosamond Journal: Neurology Date: 2018-11-14 Impact factor: 11.800
Authors: Karissa E Cottier; Emily A Galloway; Elisa C Calabrese; Margaret E Tome; Erika Liktor-Busa; John Kim; Thomas P Davis; Todd W Vanderah; Tally M Largent-Milnes Journal: eNeuro Date: 2018-07-16