Risk Score May Help Identify Migraine Patients At Risk for Stroke

Souvik Sen, MD

Results from a study assessing a newly developed model to predict stroke risk in patients with migraine with aura demonstrated that the risk score can be a useful tool for clinicians and may help direct preventive care. The findings were presented at the American Stroke Association’s 2020 International Stroke Conference (ISC), February 19-21, 2020, in Los Angeles, California.¹

“People who have migraine with aura are at increased risk for an ischemic stroke. With our new risk-prediction tool, we could start identifying those at higher risk, treat their risk factors, and lower their risk of stroke,” study author Souvik Sen, MD, MPH, professor of neurology and chair of the neurology department at the University of South Carolina School of Medicine, said in a statement.²

The prospective study evaluated 429 participants with a history of migraine with aura from the Atherosclerosis Risk in Communities Cohort (ARIC). The risk score was created using Cox proportional-hazards analysis to identify associations between potential risk factors and ischemic stroke. Once identified, points were assigned to each risk factor based on linear transformation of the corresponding β regression coefficient.

During the mean follow-up of 20-years, 31 patients developed ischemic stroke. Investigators identified 5 prognostic factors: diabetes mellitus and age >65 were assigned 7- and 5-point values, respectively; heart rate variability and hypertension were assigned a 3-point value; and gender was assigned a 1-point values. Each patient was classified into 1 of 3 different groups dependent on risk score: low risk (0 to 4 points), moderate risk (5 to 10 points), or high risk (11 to 21 points).

Compared with the low-risk group, the high-risk group was approximately 7 times more likely to experience an ischemic stroke (hazards ratios 7.35; P = .003). Additionally, investigators noted that there was significant discrimination between stroke risk values among the different risk stratification groups (P <.001).

Although the model proved to be useful for predicting stroke risk in this population, validation of the risk score in a larger, independent population cohort is warranted prior to clinical implementation.

For more coverage of ISC 2020, click here.

REFERENCES

1. Vezzetti A, Melikov P, Alonso A, et al. Migraine with aura as a risk for ischemic stroke (MARS) risk score. Presented at: 2020 International Stroke ConferencE. February 19-21, 2020; Los Angeles, CA. Abstract WMP117.

2. New model may help predict stroke risk in adults with migraine and aura. Dallas, TX: American Stroke Association. February 12, 2020. newsroom.heart.org/news/new-model-may-help-predict-stroke-risk-in-adults-with-migraine-and-aura. Accessed February 18, 2020.