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Migraine with visual aura is a risk factor for incident atrial fibrillation: A cohort study.

TitleMigraine with visual aura is a risk factor for incident atrial fibrillation: A cohort study.
Publication TypeJournal Article
Year of Publication2018
AuthorsSen S, X Androulakis M, Duda V, Alonso A, Chen LYee, Soliman EZ, Magnani J, Trivedi T, Merchant AT, Gottesman RF
Secondary AuthorsRosamond WD
JournalNeurology
Volume91
Issue24
Paginatione2202-e2210
Date Published2018 12 11
ISSN1526-632X
KeywordsAtrial Fibrillation, Brain Ischemia, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Migraine with Aura, Prospective Studies, Risk Factors, Stroke
Abstract

OBJECTIVE: Migraine with visual aura is associated with cardioembolic stroke risk. The aim of this study was to test association between migraine with visual aura and atrial fibrillation (AF), in the Atherosclerosis Risk in Communities study.

METHODS: In the Atherosclerosis Risk in Communities study, a longitudinal, community-based cohort study, participants were interviewed for migraine history in 1993-1995 and were followed for incident AF through 2013. AF was adjudicated using ECGs, discharge codes, and death certificates. Multivariable Cox proportional hazards models were used to study the relation between migraine and its subtypes with incident AF, compared with controls without headaches. Mediation analysis was conducted to test whether AF was a mediator of migraine with visual aura-associated stroke risk.

RESULTS: Of 11,939 participants assessed for headache and without prior AF or stroke, 426 reported migraines with visual aura, 1,090 migraine without visual aura, 1,018 nonmigraine headache, and 9,405 no headache. Over a 20-year follow-up period, incident AF was noted in 232 (15%) of 1,516 with migraine and 1,623 (17%) of 9,405 without headache. After adjustment for multiple confounders, migraine with visual aura was associated with increased risk of AF compared to no headache (hazard ratio 1.30, 95% confidence interval 1.03-1.62) as well as when compared to migraine without visual aura (hazard ratio 1.39, 95% confidence interval 1.05-1.83). The data suggest that AF may be a potential mediator of migraine with visual aura-stroke risk.

CONCLUSIONS: Migraine with aura was associated with increased risk of incident AF. This may potentially lead to ischemic strokes.

DOI10.1212/WNL.0000000000006650
Alternate JournalNeurology
PubMed ID30429278
PubMed Central IDPMC6329332
Grant ListHHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
16EIA26410001 / AHA / American Heart Association-American Stroke Association / United States
HHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States