Triptans and ergotamine decreased the risk of cardio-cerebrovascular disease in female migraine patients in the Korean NHIS-HEALS cohort.

Abstract

Abstract Objectives: Triptans and ergotamine are commonly used to treat migraine, a risk factor for ischemic stroke. This study aimed to investigate the association between migraine and ischemic cardio-cerebrovascular disease (CCVD). Further analyses were performed to examine whether symptom-relieving treatment of migraine with triptans and ergotamine reduces ischemic CCVD in migraineurs. Methods: Participants were divided into patients reporting headache without migraine (HA), migraineurs who received at least one prescription for triptans or ergotamine (TE), and migraineurs who were prescribed neither triptans nor ergotamine (NTNE). Ischemic CCVDs comprised ischemic cerebrovascular diseases and cardiovascular diseases. Using cox proportional hazards regression models, primary and secondary analysis for risk of ischemic CCVDs was compared. Results: The median follow-up was 6.65 years. The overall incidence rate of CCVDs was 4,728/38,590 (12.25%) in females and 3,158/23,682 (13.33%) in males. Compared with the HA group, the hazard ratios (HRs) (95% CIs) of the TE and NTNE groups for ischemic CCVDs were 1.18 (1.01–1.39) and 1.39 (1.28–1.50), respectively, in males, and 1.22 (1.09–1.37) and 1.53 (1.42–1.65), respectively, in females, after full adjustment for confounding variables. Compared with the NTNE group, the HRs (95% CIs) of the TE group for ischemic CCVDs were 0.86 (0.73–1.00) in males and 0.80 (0.72–0.88) in females. Conclusions: Migraine increased the risk of ischemic CCVDs in both sexes, but female migraineurs treated with triptans and ergotamine were at lower risk of ischemic CCVDs than female migraineurs who did not take those medications.