Migraine headache in patients with spontaneous coronary artery dissection: A report of the iSCAD Registry.
Publication Title
Vascular medicine (London, England)
Document Type
Article
Publication Date
6-1-2024
Keywords
oregon; portland; Humans; Female; Registries; Male; Migraine Disorders; Middle Aged; Vascular Diseases; Coronary Vessel Anomalies; Adult; Prospective Studies; Risk Factors; Disability Evaluation; Aged; Fibromuscular Dysplasia; Depression
Abstract
Introduction: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. Migraine headache has been reported to be common among patients with SCAD, but the degree of migraine-related disability has not been quantified.
Methods: Clinical data and headache variables were obtained from the baseline assessment of the prospective, multicenter iSCAD Registry. Migraine-related disability was quantified using the self-reported Migraine Disability Assessment (MIDAS). Demographic, clinical, psychosocial, and medical characteristics from data entry forms were compared between patients with and without migraine.
Results: Of the 773 patients with available data, 46% reported previous or current migraines. Those with migraines were more likely to be women (96.9% vs 90.3%, p = 0.0003). The presence of underlying carotid fibromuscular dysplasia was associated with migraine (35% vs 27%, p = 0.0175). There was not a significant association with carotid artery dissection and migraine. Current migraine frequency was less than monthly (58%), monthly (24%), weekly (16%), and daily (3%). Triptan use was reported in 32.5% of patients, and 17.5% used daily migraine prophylactic medications. Using the MIDAS to quantify disability related to migraine, 60.2% reported little or no disability, 14.4% mild, 12.7% moderate, and 12.7% severe. The mean MIDAS score was 9.9 (mild to moderate disability). Patients with SCAD had higher rates of depression and anxiety (28.2% vs 17.7% [p = 0.0004] and 35.3% vs 26.7% [p = 0.0099], respectively).
Conclusions: Migraines are common, frequent, and a source of disability in patients with SCAD. The association between female sex, anxiety, and depression may provide some insight for potential treatment modalities.
Keywords: fibromuscular dysplasia (FMD); migraine headache; myocardial infarction; spontaneous coronary artery dissection (SCAD).
Clinical Institute
Cardiovascular (Heart)
Clinical Institute
Neurosciences (Brain & Spine)
Clinical Institute
Mental Health
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Neurosciences
Specialty/Research Institute
Behavioral Health
DOI
10.1177/1358863X241252444
