title: Risk of Stroke in Migraineurs Using Triptans. Associations with Age, Sex, Stroke Severity and Subtype.
abstract: BACKGROUND
  Identifying migraineurs by triptan utilization we studied risk for stroke in migraineurs compared to the general population.
  
  
  METHODS
  A cohort study including all citizens 25-80years of age in Denmark 2003-2011 was conducted. All persons prescribed triptans, and all those hospitalized for a first stroke were identified in the Danish Registries. Information on stroke severity/subtype and cardiovascular risk factors was available for stroke patients.
  
  
  RESULTS
  Of the 49,711 patients hospitalized for a first stroke, 1084 were migraineurs using triptans. Adjusting for age, sex, income, and educational level, risk for stroke was higher among migraineurs in respect to all strokes (RR 1.07; CI 1.01-1.14) and ischemic strokes (RR 1.07; CI 1.00-1.14). Risk for hemorrhagic stroke was increased but only in women (RR 1.41; CI 1.11-1.79). Risk was for mild strokes (RR 1.31; CI 1.16-1.48) while risk for severe strokes was lower among migraineurs (RR 0.77; CI 0.65-0.91). Risk was age-related; highest among women 25-45years (RR≈1.7). Risk was unrelated to numbers of dispensations.
  
  
  CONCLUSIONS
  Migraineurs identified by triptan utilization had higher risk for stroke. Strokes were minor and cardiovascular risk factors were less prevalent pointing to a migraine-specific etiology of stroke different from that of thromboembolism.
authors.affiliation: Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
authors.forename: Vanna
authors.initials: V
authors.lastname: Albieri
authors.affiliation: Department of Neurology, Bispebjerg University Hospital, 2400 Copenhagen, Denmark. Electronic address: tso@dadlnet.dk.
authors.forename: Tom Skyhøj
authors.initials: TS
authors.lastname: Olsen
authors.affiliation: Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, 2100 Copenhagen, Denmark.
authors.forename: Klaus Kaae
authors.initials: KK
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced / Q000145:classification* / Q000453:epidemiology*; D014363:Tryptamines / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014363:Tryptamines
keywords: Hemorrhagic stroke; Ischemic stroke; Migraine; Stroke; Triptans