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Ischemic stroke subtypes and migraine with visual aura in the ARIC study.

TitleIschemic stroke subtypes and migraine with visual aura in the ARIC study.
Publication TypeJournal Article
Year of Publication2016
AuthorsX Androulakis M, Kodumuri N, Giamberardino LD, Rosamond WD, Gottesman RF, Yim E
Secondary AuthorsSen S
JournalNeurology
Volume87
Issue24
Pagination2527-2532
Date Published2016 Dec 13
ISSN1526-632X
KeywordsAged, Atherosclerosis, Brain Ischemia, Epilepsy, Female, Humans, Male, Middle Aged, Migraine with Aura, Prospective Studies, Risk Factors, Stroke
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.

DOI10.1212/WNL.0000000000003428
Alternate JournalNeurology
PubMed ID27956563
PubMed Central IDPMC5207003