Cecil A Rambarat1, Islam Y Elgendy2, B Delia Johnson3, Steven E Reis4, Diane V Thompson5, Barry L Sharaf6, Vera Bittner7, George Sopko8, C Noel Bairey Merz9, Carl J Pepine2, Bina Ahmed10. 1. Department of Medicine, University of Florida, Gainesville. Electronic address: cecil.rambarat@medicine.ufl.edu. 2. Division of Cardiovascular Disease, Department of Medicine, University of Florida, Gainesville. 3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. 4. Department of Medicine, University of Pittsburgh, Pa. 5. Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pa. 6. Rhode Island Hospital, Providence. 7. Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham. 8. Division of Heart and Vascular Diseases, National Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Md. 9. Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, Calif. 10. Division of Cardiovascular Disease, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
Abstract
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.
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.
Authors: B L Sharaf; C J Pepine; R A Kerensky; S E Reis; N Reichek; W J Rogers; G Sopko; S F Kelsey; R Holubkov; M Olson; N J Miele; D O Williams; C N Merz Journal: Am J Cardiol Date: 2001-04-15 Impact factor: 2.778
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