• Cecil A Rambarat, Islam Y Elgendy, B Delia Johnson, Steven E Reis, Diane V Thompson, Barry L Sharaf, Vera Bittner, George Sopko, Bairey MerzC NoelCNBarbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, Calif., Carl J Pepine, and Bina Ahmed.
• Department of Medicine, University of Florida, Gainesville. Electronic address: cecil.rambarat@medicine.ufl.edu.
• Am. J. Med. 2017 Jun 1; 130 (6): 738743738-743.

BackgroundThe association between migraine headache and cardiovascular events has been inconsistent. This study determines the long-term risk of cardiovascular events among women with and without a history of migraine headache who were under evaluation for suspected myocardial ischemia in the Women's Ischemia Syndrome Evaluation (WISE).MethodsThe WISE is a National Heart, Lung and Blood Institute-sponsored prospective, multicenter study that aims to improve myocardial ischemia evaluation in women. A total of 936 women presenting with symptoms of myocardial ischemia underwent structured data collection and coronary angiography. Information pertaining to migraine headache was available in 917 women. All-cause mortality data were available on all women for a median of 9.5 years, and nonfatal cardiovascular event data were available on 888 women for a median of 6.5 years.ResultsA total of 224 (24.4%) women reported a history of migraine headache. Compared with women who did not report a history of migraine headache, women with a history of migraine headache had an increased adjusted risk of cardiovascular event (cardiovascular death, nonfatal myocardial infarction, heart failure, or stroke) (hazard ratio 1.83; 95% confidence interval, 1.22-2.75) at a median follow-up of 6.5 years. This result was driven mainly by a twofold increase in the risk of stroke (hazard ratio 2.33; 95% confidence interval, 1.16-4.68).ConclusionAmong women being evaluated for ischemic heart disease, those reporting a history of migraine headache had increased risk of future cardiovascular events on long-term follow-up. This risk was primarily driven by a more-than twofold increase in the risk of stroke.Copyright © 2017 Elsevier Inc. All rights reserved.

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