title: Migraines, angiographic coronary artery disease and cardiovascular outcomes in women.
abstract: OBJECTIVE
  There are conflicting data regarding the association between migraines and cardiovascular events. We evaluated the relationship between migraine headaches, angiographic coronary artery disease, and cardiovascular events in women.
  
  
  METHODS
  The Women's Ischemia Syndrome Evaluation (WISE) study is a National Heart, Lung and Blood Institute (NHLBI)-sponsored prospective, multicenter study aiming to improve ischemia evaluation in women. A total of 944 women presenting with chest pain or symptoms suggestive of myocardial ischemia were enrolled and underwent complete demographic, medical, and psychosocial history, physical examination, and coronary angiography testing. A smaller subset of 905 women, representing a mean age of 58 years, answered questions regarding a history of migraines. We prospectively followed 873 women for 4.4 years for cardiovascular events and all-cause mortality.
  
  
  RESULTS
  Women reporting a history of migraines (n=220) had lower angiographic coronary severity scores, and less severe (> or = 70% luminal stenosis) angiographic coronary artery disease compared to women without a history of migraines (n=685). These differences remained statistically significant after adjustment for age and other important cardiac risk factors. On prospective follow-up of a median of 4.4 years, women with a history of migraines were not more likely to have a cardiovascular event (hazard ratio [HR] 1.2; 95% confidence interval [CI], 0.93-1.58) and migraines did not predict all-cause mortality (HR 0.96; 95% CI, 0.49-1.99).
  
  
  CONCLUSIONS
  Among women undergoing coronary angiography for suspected ischemia, those reporting migraines had less severe angiographic coronary artery disease. We could not support an association between migraines and cardiovascular events or death. Further research studying the common pathophysiology underlying migraines and cardiovascular disease is warranted.
authors.affiliation: Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif, USA.
authors.forename: Bina
authors.initials: B
authors.lastname: Ahmed
authors.forename: C Noel
authors.initials: CN
authors.lastname: Bairey Merz
authors.forename: Candace
authors.initials: C
authors.lastname: McClure
authors.forename: B Delia
authors.initials: BD
authors.lastname: Johnson
authors.forename: Steve E
authors.initials: SE
authors.lastname: Reis
authors.forename: Vera
authors.initials: V
authors.lastname: Bittner
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Pepine
authors.forename: Barry L
authors.initials: BL
authors.lastname: Sharaf
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: Leslee
authors.initials: L
authors.lastname: Shaw
mesh_terms: D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D009203:Myocardial Infarction / Q000150:complications; D012307:Risk Factors