Migraines, angiographic coronary artery disease and cardiovascular outcomes in women.
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.
Ahmed
Bina
B
Division of Cardiology, Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, Calif, USA.
Bairey Merz
C Noel
CN
McClure
Candace
C
Johnson
B Delia
BD
Reis
Steve E
SE
Bittner
Vera
V
Pepine
Carl J
CJ
Sharaf
Barry L
BL
Sopko
George
G
Kelsey
Sheryl F
SF
Shaw
Leslee
L
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