Migraine and the risk of cardiovascular and cerebrovascular events: a meta-analysis of 16 cohort studies including 1 152 407 subjects.
Migraine and the risk of cardiovascular and cerebrovascular events: a meta-analysis of 16 cohort studies including 1 152 407 subjects.
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DOI：
10.1136/bmjopen-2017-020498
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发表时间：
2018-03-27
期刊：
影响因子：
2.9
通讯作者：
Elgendy IY
中科院分区：
文献类型：
--
作者：
Mahmoud AN;Mentias A;Elgendy AY;Qazi A;Barakat AF;Saad M;Mohsen A;Abuzaid A;Mansoor H;Mojadidi MK;Elgendy IY
进行一项更新的荟萃分析，以评估偏头痛患者的长期心血管和脑血管结局。根据系统性综述和荟萃分析指南的首选报告项目对队列研究进行荟萃分析。检索MEDLINE、Web of Science和科克伦对照试验中心注册数据库中的相关文章。共分析了16项队列研究（18项研究记录），其中包括394942名偏头痛患者和757465名非偏头痛患者。主要不良心血管和脑血管事件（MACCE）、卒中（即缺血性、出血性或未指明）、心肌梗死（MI）和全因死亡率。在最长可用随访时报告结局。通过随机效应Der-Simonian和Liard模型计算汇总校正的风险比（HR）。采用Newcastle-Ottawa量表评估偏倚风险。偏头痛与MACCE的高风险相关（校正HR 1.42，95%置信区间[CI] 1.26至1.60，P<0.001，I2=40%），由卒中风险较高驱动（校正HR 1.41，95% CI 1.25 - 1.61，P<0.001，I2=72%）和MI（校正HR 1.23，95% CI 1.03 - 1.43，P=0.006，I2=59%）。全因死亡风险无差异（校正HR 0.93，95% CI 0.78 - 1.10，P=0.38，I2=91%），研究间存在相当程度的统计学异质性。先兆的存在是中风的一个影响因素（校正HR先兆1.56，95% CI 1.30 - 1.87 vs校正HR无先兆1.11，95% CI 0.94 - 1.31，P交互作用=0.01）和全因死亡率（校正HR先兆1.20，95% CI 1.12 ~ 1.30 vs校正HR无先兆0.96，95% CI 0.86 ~ 1.07，P交互作用<0.001）。偏头痛与心血管和脑血管事件的长期风险增加相关。该效应是由于卒中（缺血性和出血性）和MI风险增加所致。结果存在中度至重度异质性，部分原因是先兆的存在。 CRD 42016052460。
To perform an updated meta-analysis to evaluate the long-term cardiovascular and cerebrovascular outcomes among migraineurs. A meta-analysis of cohort studies performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials databases were searched for relevant articles. A total of 16 cohort studies (18 study records) with 394 942 migraineurs and 757 465 non-migraineurs were analysed. Major adverse cardiovascular and cerebrovascular events (MACCE), stroke (ie, ischaemic, haemorrhagic or non-specified), myocardial infarction (MI) and all-cause mortality. The outcomes were reported at the longest available follow-up. Summary-adjusted hazard ratios (HR) were calculated by random-effects Der-Simonian and Liard model. The risk of bias was assessed by the Newcastle-Ottawa Scale. Migraine was associated with a higher risk of MACCE (adjusted HR 1.42, 95% confidence interval [CI] 1.26 to 1.60, P<0.001, I2=40%) driven by a higher risk of stroke (adjusted HR 1.41, 95% CI 1.25 to 1.61, P<0.001, I2=72%) and MI (adjusted HR 1.23, 95% CI 1.03 to 1.43, P=0.006, I2=59%). There was no difference in the risk of all-cause mortality (adjusted HR 0.93, 95% CI 0.78 to 1.10, P=0.38, I2=91%), with a considerable degree of statistical heterogeneity between the studies. The presence of aura was an effect modifier for stroke (adjusted HR aura 1.56, 95% CI 1.30 to 1.87 vs adjusted HR no aura 1.11, 95% CI 0.94 to 1.31, P interaction=0.01) and all-cause mortality (adjusted HR aura 1.20, 95% CI 1.12 to 1.30 vs adjusted HR no aura 0.96, 95% CI 0.86 to 1.07, Pinteraction<0.001). Migraine headache was associated with an increased long-term risk of cardiovascular and cerebrovascular events. This effect was due to an increased risk of stroke (both ischaemic and haemorrhagic) and MI. There was a moderate to severe degree of heterogeneity for the outcomes, which was partly explained by the presence of aura. CRD42016052460.
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影响因子：
9.9
作者：
Androulakis, X. Michelle;Kodumuri, Nishanth;Sen, Souvik
通讯作者：
Sen, Souvik
影响因子：
120.7
作者：
Kurth, Tobias;Gaziano, J. Michael;Buring, Julie E.
通讯作者：
Buring, Julie E.
影响因子：
9.9
作者：
Lipton, R. B.;Bigal, M. E.;Stewart, W. F.
通讯作者：
Stewart, W. F.
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
9.9
作者：
Kurth, T;Slomke, MA;Buring, JE
通讯作者：
Buring, JE