George Koshy Vilanilam, MBBS: Migraine as a Risk Factor for Ischemic Stroke

“We found that there has been an increasing trend over those 6 years—2008 to 2014—irrespective of the aura status.”

It has been documented in the literature that the risk of ischemic stroke is twice as high in patients with migraine with aura compared to patients without aura. Not only that, but this has this been linked to cerebral hyperactivity.

In order to assess the trends and identify the risk factors for these patients developing ischemic stroke, George Koshy Vilanilam, MBBS, and colleagues, utilized the National Inpatient Sample to assess a population of almost 800,000 patients with migraine. What they found is that there has been a significant increasing trend in patients with migraine—irrespective of aura status—having an ischemic stroke.

Ultimately, the findings revealed that 3.89% (95% CI, 3.62 to 4.16) of patients developed stroke in aura compared to 1.78% (95% CI, 1.74 to 1.82%) without aura. They also showed that the trends of stroke from 2008 to 2014 were trending upward in both the population of those with migraine with aura (P = .0003) and without aura (P <.0001).¹

They also found that patent foramen ovale, atrial fibrillation, a hypercoagulable state, hypertension, hyperlipidemia, and chronic use of antithrombotics all raised the risk of ischemic stroke in patients with migraine.

At the 143rd Annual Meeting of the American Neurological Association in Atlanta, Georgia, NeurologyLive sat down with Vilanilam to discuss the trial and some of the more surprising findings.

REFERENCE

Patel SD, Agarwal K, Patel N, et al. Trend and predictors of ischemic stroke in migraineurs aura population: US study. Presented at: 143 ANA Annual Meeting; Atlanta, Georga; October 21 to 23, 2018. Abstract M135.