Migraine with aura linked to cardioembolic, thrombotic strokes
Patients who have migraines with aura are three times more likely to experience a cardioembolic stroke and two times more likely to experience a thrombotic stroke compared with patients who have migraine without aura, according to research presented at the International Stroke Conference.
“Since migraines alter the blood vessels in the brain, the greater incidence of strokes caused by blood clots in the heart or the brain’s blood vessels suggest that migraine also affects blood vessels supplying blood to the brain,” Souvik Sen, MD, MPH, chairman of neurology at the University of South Carolina School of Medicine, said in a press release. “That’s what possible leads to these specific subtypes of stroke.”
Sen and colleagues analyzed data from the ongoing, prospective Atherosclerosis Risk in Communities (ARIC) study to evaluate the relationship between migraine with and without aura and stroke subtypes, specifically large artery atherosclerosis, cardioembolism and small vessel occlusion. The analysis included 12,844 participants. More than half of the patients were white and female.
Overall, 12.7% of participants had migraine, 8.5% had non-migraine headache and 29% had migraine with aura.
From baseline in 1987-1989 to 2012, 817 ischemic strokes were reported. Of those strokes, 51% were thrombotic, 27% were cardioembolic and 22% were lacunar.
The risk for stroke overall was higher among participants with migraine with aura compared with those who had migraines without aura (adjusted HR = 2; 95% CI, 1.2-3.4; P = .01). Migraine with aura had the strongest association with cardioembolic stroke (HR = 3.3; 95% CI, 1.4-8; P = .009) and thrombotic stroke (HR = 2; 95% CI, 1.2-3.4; P = .01).
These results are “in agreement with the previous studies which reported increased risk of stroke in migraine with aura,” Sen said during a press conference. “As our results point to the significant association of stroke with migraine, it emphasizes the importance of specific diagnostic testing to assess for cardioembolism and stroke prevention in migraine with aura patients.” – by Tracey Romero
Sen S, et al. Poster 3918/T P179. Presented at: International Stroke Conference; Feb. 16-19, 2016; Los Angeles.
Disclosure: The researchers report no relevant financial disclosures.