Aneurysmal subarachnoid hemorrhage in patients with migraine and tension headache: A cohort comparison study
| Autor: | Justin M. Moore, Hriday P. Bhambhvani, John K. Ratliff, Ajith J. Thomas, Layton Lamsam |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage Tension headache Migraine Disorders Cohort Studies 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Risk Factors Physiology (medical) Internal medicine medicine Humans Risk factor Retrospective Studies Analgesics business.industry Incidence Incidence (epidemiology) General Medicine Middle Aged Subarachnoid Hemorrhage medicine.disease Neurology Migraine 030220 oncology & carcinogenesis Cohort Female Surgery Neurology (clinical) Headaches medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neuroscience. 79:90-94 |
| ISSN: | 0967-5868 |
| Popis: | Migraine headache is a common condition with an estimated lifetime prevalence of greater than 20%. While it is a well-established risk factor for cardiovascular disease and ischemic stroke, its association with subarachnoid hemorrhage is largely unexplored. We sought to compare the incidence of aneurysmal subarachnoid hemorrhage in a cohort of migraine patients with a cohort of patients with tension headache. A cohort comparison study utilizing the MarketScan insurance claims database compared patients diagnosed with migraine who were undergoing treatment with abortive or prophylactic pharmacotherapy (treatment cohort) and patients diagnosed with tension headache who had never been diagnosed with a migraine and who were naive to migraine pharmacotherapy (control cohort). Patients with major pre-existing risk factors for aSAH were excluded from the study, and minor risk factors such as smoking status and hypertension were accounted for using coarsened exact matching (CEM) and subsequent cox proportional-hazards (CPH) regression. More than 679,000 patients (~125,000 treatment and ~ 550,000 control) with an average follow-up of more than three years were analyzed for aneurysmal subarachnoid hemorrhage. CPH regression on matched data showed that treated migraine patients had a significantly lower hazard of aneurysmal subarachnoid hemorrhage compared with tension headache patients (HR = 0.40, 95% CI: 0.19 – 0.86, p = 0.02). This large cohort comparison study, analyzing more than 679,000 patients, demonstrated that migraine patients undergoing pharmacologic treatment had a lower hazard of aneurysmal subarachnoid hemorrhage than patients diagnosed with tension headaches. Future work specifically focusing on migraine medications may identify the mechanisms underlying this association. |
| Databáze: | OpenAIRE |
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