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Meta-Analysis
. 2022 May;269(5):2346-2358.
doi: 10.1007/s00415-021-10930-x. Epub 2022 Jan 8.

Myocardial infarction, stroke and cardiovascular mortality among migraine patients: a systematic review and meta-analysis

Chester Yan Hao Ng #  1 , Benjamin Y Q Tan #  1   2 , Yao Neng Teo  1 , Yao Hao Teo  1 , Nicholas L X Syn  1 , Aloysius S T Leow  1 , Jamie S Y Ho  3 , Mark Y Chan  1   4 , Raymond C C Wong  1   4 , Ping Chai  1   4 , Amanda Chee Yun Chan  1   2 , Vijay Kumar Sharma  1   2 , Leonard L L Yeo  1   2 , Ching-Hui Sia #  5   6 , Jonathan J Y Ong #  1   2
Affiliations
Meta-Analysis

Myocardial infarction, stroke and cardiovascular mortality among migraine patients: a systematic review and meta-analysis

Chester Yan Hao Ng et al. J Neurol. 2022 May.

Abstract

Background: An increasing number of studies have shown an association between migraine and cardiovascular disease, in particular cardio- and cerebro-vascular events.

Methods: Three electronic databases (PubMed, Embase and Scopus) were searched from inception to May 22, 2021 for prospective cohort studies evaluating the risk of myocardial infarction, stroke and cardiovascular mortality in migraine patients. A random effects meta-analysis model was used to summarize the included studies.

Results: A total of 18 prospective cohort studies were included consisting of 370,050 migraine patients and 1,387,539 controls. Migraine was associated with myocardial infarction (hazard ratio, 1.36; 95% CI, 1.23-1.51; p = < 0.001), unspecified stroke (hazard ratio, 1.30; 95% CI, 1.07-1.60; p = 0.01), ischemic stroke (hazard ratio, 1.35; 95% CI, 1.03-1.78; p = 0.03) and hemorrhagic stroke (hazard ratio, 1.43; 95% CI, 1.07-1.92; p = 0.02). Subgroup analysis of migraine with aura found a further increase in risk of myocardial infarction and both ischemic and hemorrhagic stroke, as well as improved substantial statistical heterogeneity. Migraine with aura was also associated with an increased risk of cardiovascular mortality (hazard ratio, 1.27; 95% CI, 1.14-1.42; p = < 0.001).

Conclusion: Migraine, especially migraine with aura, is associated with myocardial infarction and stroke. Migraine with aura increases the risk of overall cardiovascular mortality.

Keywords: Aura; Migraine; Mortality; Myocardial infarction; Stroke.

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