TY - JOUR
T1 - Migraine with visual aura is a risk factor for incident atrial fibrillation
T2 - A cohort study
AU - Sen, Souvik
AU - Michelle Androulakis, X.
AU - Duda, Viktoriya
AU - Alonso, Alvaro
AU - Chen, Lin Yee
AU - Soliman, Elsayed Z.
AU - Magnani, Jared
AU - Trivedi, Tushar
AU - Merchant, Anwar T.
AU - Gottesman, Rebecca F.
AU - Rosamond, Wayne D.
N1 - Publisher Copyright:
Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
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U2 - 10.1212/WNL.0000000000006650
DO - 10.1212/WNL.0000000000006650
M3 - Article
C2 - 30429278
AN - SCOPUS:85058612783
SN - 0028-3878
VL - 91
SP - E2202-E2210
JO - Neurology
JF - Neurology
IS - 24
ER -
