Association between migraine and risk of venous thromboembolism: A nationwide cohort study

Kuan Po Peng, Yung Tai Chen, Jong Ling Fuh, Chao Hsiun Tang, Shuu Jiun Wang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background.—The link between arterial thromboembolism and migraine is well-documented; however, few studies investigated the link between venous thromboembolism (VTE) and migraine. We aimed to evaluate the association between migraine and VTE and to examine whether demographics or comorbid risk factors modulate VTE development. Methods.—We conducted a cohort study accessing a nationwide claims-based database with an adult cohort of 102,159 neurologist-diagnosed migraine patients, and 102,159 nonheadache comparison subjects, matched on sex and propensity score for the diagnosis of migraine. Both cohorts were followed until the end of 2010, death, or VTE development. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards regression analyses and compared between the two groups. Results.—During a mean follow-up period of 4.2 years, VTE developed in 226 patients (460,047 person-years) in the migraine cohort and in 203 subjects (462,401 person-years) in the comparison cohort. Overall, likelihood of VTE for the migraine cohort did not differ from that in the comparison cohort (aHR 1.12; 95% CI, 0.92–1.35; P =.251). However, subgroup analysis by migraine subtypes (P =.004 for interaction) revealed an elevated risk of VTE in patients with migraine with aura (aHR 2.42; 95% CI, 1.40–4.19; P =.002), but not in those with migraine without aura. The association was not altered in subsequent subgroup analyses and sensitivity analyses. Conclusions Risk of VTE development is elevated specifically in patients diagnosed with migraine with aura. This association suggests a linked disease mechanism and warrants further exploration.

Original languageEnglish
Pages (from-to)1290-1299
Number of pages10
JournalHeadache
Volume56
Issue number8
DOIs
Publication statusPublished - 2016

Fingerprint

Venous Thromboembolism
Migraine Disorders
Cohort Studies
Migraine with Aura
Confidence Intervals
Migraine without Aura
Propensity Score
Thromboembolism
Regression Analysis
Demography
Databases

Keywords

  • aura
  • deep vein thrombosis
  • migraine
  • pulmonary embolism
  • venous thromboembolism

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Association between migraine and risk of venous thromboembolism : A nationwide cohort study. / Peng, Kuan Po; Chen, Yung Tai; Fuh, Jong Ling; Tang, Chao Hsiun; Wang, Shuu Jiun.

In: Headache, Vol. 56, No. 8, 2016, p. 1290-1299.

Research output: Contribution to journalArticle

Peng, Kuan Po ; Chen, Yung Tai ; Fuh, Jong Ling ; Tang, Chao Hsiun ; Wang, Shuu Jiun. / Association between migraine and risk of venous thromboembolism : A nationwide cohort study. In: Headache. 2016 ; Vol. 56, No. 8. pp. 1290-1299.
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abstract = "Background.—The link between arterial thromboembolism and migraine is well-documented; however, few studies investigated the link between venous thromboembolism (VTE) and migraine. We aimed to evaluate the association between migraine and VTE and to examine whether demographics or comorbid risk factors modulate VTE development. Methods.—We conducted a cohort study accessing a nationwide claims-based database with an adult cohort of 102,159 neurologist-diagnosed migraine patients, and 102,159 nonheadache comparison subjects, matched on sex and propensity score for the diagnosis of migraine. Both cohorts were followed until the end of 2010, death, or VTE development. Adjusted hazard ratios (aHRs) and 95{\%} confidence intervals (CIs) were calculated based on Cox proportional hazards regression analyses and compared between the two groups. Results.—During a mean follow-up period of 4.2 years, VTE developed in 226 patients (460,047 person-years) in the migraine cohort and in 203 subjects (462,401 person-years) in the comparison cohort. Overall, likelihood of VTE for the migraine cohort did not differ from that in the comparison cohort (aHR 1.12; 95{\%} CI, 0.92–1.35; P =.251). However, subgroup analysis by migraine subtypes (P =.004 for interaction) revealed an elevated risk of VTE in patients with migraine with aura (aHR 2.42; 95{\%} CI, 1.40–4.19; P =.002), but not in those with migraine without aura. The association was not altered in subsequent subgroup analyses and sensitivity analyses. Conclusions Risk of VTE development is elevated specifically in patients diagnosed with migraine with aura. This association suggests a linked disease mechanism and warrants further exploration.",
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N2 - Background.—The link between arterial thromboembolism and migraine is well-documented; however, few studies investigated the link between venous thromboembolism (VTE) and migraine. We aimed to evaluate the association between migraine and VTE and to examine whether demographics or comorbid risk factors modulate VTE development. Methods.—We conducted a cohort study accessing a nationwide claims-based database with an adult cohort of 102,159 neurologist-diagnosed migraine patients, and 102,159 nonheadache comparison subjects, matched on sex and propensity score for the diagnosis of migraine. Both cohorts were followed until the end of 2010, death, or VTE development. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards regression analyses and compared between the two groups. Results.—During a mean follow-up period of 4.2 years, VTE developed in 226 patients (460,047 person-years) in the migraine cohort and in 203 subjects (462,401 person-years) in the comparison cohort. Overall, likelihood of VTE for the migraine cohort did not differ from that in the comparison cohort (aHR 1.12; 95% CI, 0.92–1.35; P =.251). However, subgroup analysis by migraine subtypes (P =.004 for interaction) revealed an elevated risk of VTE in patients with migraine with aura (aHR 2.42; 95% CI, 1.40–4.19; P =.002), but not in those with migraine without aura. The association was not altered in subsequent subgroup analyses and sensitivity analyses. Conclusions Risk of VTE development is elevated specifically in patients diagnosed with migraine with aura. This association suggests a linked disease mechanism and warrants further exploration.

AB - Background.—The link between arterial thromboembolism and migraine is well-documented; however, few studies investigated the link between venous thromboembolism (VTE) and migraine. We aimed to evaluate the association between migraine and VTE and to examine whether demographics or comorbid risk factors modulate VTE development. Methods.—We conducted a cohort study accessing a nationwide claims-based database with an adult cohort of 102,159 neurologist-diagnosed migraine patients, and 102,159 nonheadache comparison subjects, matched on sex and propensity score for the diagnosis of migraine. Both cohorts were followed until the end of 2010, death, or VTE development. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated based on Cox proportional hazards regression analyses and compared between the two groups. Results.—During a mean follow-up period of 4.2 years, VTE developed in 226 patients (460,047 person-years) in the migraine cohort and in 203 subjects (462,401 person-years) in the comparison cohort. Overall, likelihood of VTE for the migraine cohort did not differ from that in the comparison cohort (aHR 1.12; 95% CI, 0.92–1.35; P =.251). However, subgroup analysis by migraine subtypes (P =.004 for interaction) revealed an elevated risk of VTE in patients with migraine with aura (aHR 2.42; 95% CI, 1.40–4.19; P =.002), but not in those with migraine without aura. The association was not altered in subsequent subgroup analyses and sensitivity analyses. Conclusions Risk of VTE development is elevated specifically in patients diagnosed with migraine with aura. This association suggests a linked disease mechanism and warrants further exploration.

KW - aura

KW - deep vein thrombosis

KW - migraine

KW - pulmonary embolism

KW - venous thromboembolism

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