(2) The Impact of Sex on Migraine-Associated Risks of Premature Stroke and Myocardial Infarction: A Danish Population-Based Cohort Study

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 676

Presenting Author(s)

Cecilia H. Fuglsang
– Department of Clinical Epidemiology, Aarhus University, Aarhus N, Midtjylland, Denmark

Co-Author(s)

Morten Schmidt
– Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark, Denmark
Lars Pedersen, MSc, PhD
– Professor, Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark, Denmark
Henrik Toft Sørensen, MD, PhD, DMSc, DSc
– Professor & Chair, Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark, Midtjylland, Denmark

Background: Migraine is an established risk factor for stroke and myocardial infarction (MI). Migraine primarily affects young women. The risk of premature (i.e. among young adults) stroke and MI differs according to sex.

Objectives: We examined the impact of sex on migraine-associated risks of premature stroke and MI (age 60 or younger).

Methods: Using Danish medical registries, we conducted a nationwide population based cohort study during 1996–2016. Individuals with migraine were identified by redeemed prescriptions for migraine specific medication. Five members matched on age, sex, and calendar year from the general population were selected for each migraine patient. We calculated the cumulative incidence with 95% confidence intervals (CI) for 21-years of follow-up as a measure of the absolute risk (AR) of premature stroke and MI for women and men with and without migraine. We used Cox regression to compute hazard ratios (HR) adjusted for age, calendar period, and comorbidities comparing individuals with migraine to those without of the same sex.

Results: We identified 198,542 individuals with migraine (82% female). AR of premature MI was 1.2% (95% CI: 1.1-1.3) for women without migraine and 1.6% (95% CI: 1.3-1.8) for women with migraine. AR of premature MI was 3.5% (95% CI: 3.3-3.8) for men without migraine 3.8% (95% CI: 3.2-4.3) for men with migraine. The HR for MI comparing individuals with migraine to those without was 1.16 (95% CI: 1.07-1.24) among women and 1.07 (95% CI: 0.97-1.17) among men. AR of premature stroke was 2.4% (95% CI: 2.3-2.5) for women without migraine and 3.0% (95% CI: 2.8-3.3) for women with migraine. AR of premature stroke was 3.4% (95% CI: 2.8-3.3) for men without migraine and 4.2% (95% CI: 3.6-4.8) for men with migraine.). The HR of premature stroke comparing individuals with migraine to those without was 1.24 (95% CI: 1.18-1.31) among women and 1.15 (95% CI: 1.05-1.25) among men.

Conclusions: Migraine is a risk factor for premature MI and in particular for premature stroke. There was no compelling evidence of effect measure modification by sex on the impact of migraine.