Consensus statement: cardiovascular safety profile of triptans (5-HT agonists) in the acute treatment of migraine.
BACKGROUND
Health care providers frequently cite concerns about cardiovascular safety of the triptans as a barrier to their use. In 2002, the American Headache Society convened the Triptan Cardiovascular Safety Expert Panel to evaluate the evidence on triptan-associated cardiovascular risk and to formulate consensus recommendations for making informed decisions for their use in patients with migraine.


OBJECTIVE
To summarize the evidence reviewed by the Triptan Cardiovascular Safety Expert Panel and their recommendations for the use of triptans in clinical practice.


METHODS
The Triptan Cardiovascular Safety Expert Panel was composed of a multidisciplinary group of experts in neurology, primary care, cardiology, pharmacology, women's health, and epidemiology.


METHODS
An exhaustive search of the relevant published literature was reviewed by each panel member in preparation for an open roundtable meeting. Pertinent issues (eg, cardiovascular pharmacology of triptans, epidemiology of cardiovascular disease, cardiovascular risk assessment, migraine) were presented as a prelude to group discussion and formulation of consensus conclusions and recommendations. Follow-up meetings were held by telephone.


CONCLUSIONS
(1) Most of the data on triptans are derived from patients without known coronary artery disease. (2) Chest symptoms occurring during use of triptans are generally nonserious and are not explained by ischemia. (3) The incidence of serious cardiovascular events with triptans in both clinical trials and clinical practice appears to be extremely low. (4) The cardiovascular risk-benefit profile of triptans favors their use in the absence of contraindications.
Dodick
David
D
Department of Neurology, Mayo Clinic Scottsdale, AZ 85259, USA.
Lipton
Richard B
RB
Martin
Vincent
V
Papademetriou
Vasilios
V
Rosamond
Wayne
W
MaassenVanDenBrink
Antoinette
A
Loutfi
Hassan
H
Welch
K Michael
KM
Goadsby
Peter J
PJ
Hahn
Steven
S
Hutchinson
Susan
S
Matchar
David
D
Silberstein
Stephen
S
Smith
Timothy R
TR
Purdy
R Allan
RA
Saiers
Jane
J
D000208:Acute Disease; D002637:Chest Pain / Q000139:chemically induced; D003327:Coronary Disease / Q000139:chemically induced*; D019317:Evidence-Based Medicine; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy*; D017366:Serotonin Receptor Agonists / Q000009:adverse effects* / Q000627:therapeutic use
D017366:Serotonin Receptor Agonists