Cardiac sources of cerebral embolism in people with migraine
V. De Giuli
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorM. Grassi
Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Unità di Statistica Medica e Genomica, Università di Pavia, Pavia, Italy
Search for more papers by this authorM. Locatelli
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorM. Gamba
Neurologia Vascolare, Stroke Unit, Spedali Civili di Brescia, Brescia, Italy
Search for more papers by this authorA. Morotti
UO Neurologia, Ospedale di Esine, ASST della Vallecamonica, Esine, Italy
Search for more papers by this authorS. Bonacina
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorV. Mazzoleni
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorD. Pezzini
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorM. Magoni
Neurologia Vascolare, Stroke Unit, Spedali Civili di Brescia, Brescia, Italy
Search for more papers by this authorR. Monastero
Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
Search for more papers by this authorA. Padovani
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorCorresponding Author
A. Pezzini
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Correspondence: A. Pezzini, Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italia (tel.: +39 030 3384086; fax: +39 030 3384086; e-mail: [email protected]; [email protected]).
Search for more papers by this authorV. De Giuli
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorM. Grassi
Dipartimento di Scienze del Sistema Nervoso e del Comportamento, Unità di Statistica Medica e Genomica, Università di Pavia, Pavia, Italy
Search for more papers by this authorM. Locatelli
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorM. Gamba
Neurologia Vascolare, Stroke Unit, Spedali Civili di Brescia, Brescia, Italy
Search for more papers by this authorA. Morotti
UO Neurologia, Ospedale di Esine, ASST della Vallecamonica, Esine, Italy
Search for more papers by this authorS. Bonacina
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorV. Mazzoleni
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorD. Pezzini
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorM. Magoni
Neurologia Vascolare, Stroke Unit, Spedali Civili di Brescia, Brescia, Italy
Search for more papers by this authorR. Monastero
Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università di Palermo, Palermo, Italy
Search for more papers by this authorA. Padovani
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Search for more papers by this authorCorresponding Author
A. Pezzini
Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy
Correspondence: A. Pezzini, Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, P.le Spedali Civili, 1, 25123 Brescia, Italia (tel.: +39 030 3384086; fax: +39 030 3384086; e-mail: [email protected]; [email protected]).
Search for more papers by this authorAbstract
Background and purpose
Whether the reported association between migraine with aura (MA) and cardioembolic stroke may be explained by a higher rate of atrial fibrillation (AF) or by other potential cardiac sources of cerebral embolism remains to be determined.
Methods
In the setting of a single centre cohort study of consecutive patients with acute brain ischaemia stratified by migraine status, the association between AF as well as patent foramen ovale (PFO) and migraine was explored.
Results
In all, 1738 patients (1017 [58.5%] men, mean age 67.9 ± 14.9 years) qualified for the analysis. Aging was inversely associated with migraine, whilst women had a >3-fold increased disease risk (odds ratio [OR] 3.82, 95% confidence interval [CI] 2.58–5.66). No association between AF and history of migraine or its pathogenic subtypes was detected. Conversely, migraine was associated with PFO, both in the entire cohort (OR 1.84, 95% CI 1.07–3.16) and in patients aged ≤55 years (OR 2.21, 95% CI 1.16–4.22). This association was significant for MA (OR 2.92, 95% CI 1.32–6.45 in the entire cohort; OR 2.92, 95% CI 1.15–7.41 in patients aged ≤55 years) and in women (OR 8.23, 95% CI 2.06–32.77), but not for migraine without aura.
Conclusions
In patients with brain ischaemia migraine is not associated with AF. Conversely, there is a probable relation between migraine, especially MA, and PFO in patients who are younger and have a more favourable vascular risk factor profile, and in women.
Disclosure of conflicts of interest
The authors declare no financial or other conflicts of interest.
Supporting Information
| Filename | Description |
|---|---|
| ene14556-sup-0001-TableS1-S5.docWord document, 47.5 KB |
Table S1. Migraine–atrial fibrillation detected before stroke occurrence ORs according to multinomial logistic regression models in the entire cohort and in the subgroup of patients aged >55 years. Table S2. Migraine–atrial fibrillation detected before stroke occurrence ORs according to multinomial logistic regression models in sex categories. Table S3. Migraine–atrial fibrillation detected after stroke occurrence ORs according to multinomial logistic regression models in the entire cohort and in the subgroup of patients aged >55 years. Table S4. Migraine–atrial fibrillation detected after stroke occurrence ORs according to multinomial logistic regression models in sex categories. Table S5. Migraine–atrial fibrillation ORs according to multinomial logistic regression models in the cohort of patients with ischaemic stroke and in the subgroup of patients aged >55 years. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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