Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
Background: An increased risk of stroke in patients with migraine has been primarily found for women. The sex-dependent mechanisms underlying the migraine–stroke association, however, remain unknown. This study aims to explore these sex differences to improve our understanding of pathophysiological...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2021.740639/full |
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| author | Katie M. Linstra Katie M. Linstra Hendrikus J. A. van Os Ynte M. Ruigrok Paul J. Nederkoorn Ewoud J. van Dijk L. Jaap Kappelle Peter J. Koudstaal Marieke C. Visser Michel D. Ferrari Antoinette MaassenVanDenBrink Gisela M. Terwindt Marieke J. H. Wermer |
| author_facet | Katie M. Linstra Katie M. Linstra Hendrikus J. A. van Os Ynte M. Ruigrok Paul J. Nederkoorn Ewoud J. van Dijk L. Jaap Kappelle Peter J. Koudstaal Marieke C. Visser Michel D. Ferrari Antoinette MaassenVanDenBrink Gisela M. Terwindt Marieke J. H. Wermer |
| author_sort | Katie M. Linstra |
| collection | DOAJ |
| description | Background: An increased risk of stroke in patients with migraine has been primarily found for women. The sex-dependent mechanisms underlying the migraine–stroke association, however, remain unknown. This study aims to explore these sex differences to improve our understanding of pathophysiological mechanisms behind the migraine–stroke association.Methods: We included 2,492 patients with ischemic stroke from the prospective multicenter Dutch Parelsnoer Institute Initiative study, 425 (17%) of whom had a history of migraine. Cardiovascular risk profile, stroke cause (TOAST classification), and outcome [modified Rankin scale (mRS) at 3 months] were compared with both sexes between patients with and without migraine.Results: A history of migraine was not associated with sex differences in the prevalence of conventional cardiovascular risk factors. Women with migraine had an increased risk of stroke at young age (onset < 50 years) compared with women without migraine (RR: 1.7; 95% CI: 1.3–2.3). Men with migraine tended to have more often stroke in the TOAST category other determined etiology (RR: 1.7; 95% CI: 1.0–2.7) in comparison with men without migraine, whereas this increase was not found in women with migraine. Stroke outcome was similar for women with or without migraine (mRS ≥ 3 RR 1.1; 95% CI 0.7–1.5), whereas men seemed to have a higher risk of poor outcome compared with their counterparts without migraine (mRS ≥ 3 RR: 1.5; 95% CI: 1.0–2.1).Conclusion: Our results indicate possible sex differences in the pathophysiology underlying the migraine–stroke association, which are unrelated to conventional cardiovascular risk factors. Further research in larger cohorts is needed to validate these findings. |
| first_indexed | 2024-12-18T01:01:31Z |
| format | Article |
| id | doaj.art-e56110384d3842ab83e6a29ec2a3cdf3 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-12-18T01:01:31Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-e56110384d3842ab83e6a29ec2a3cdf32022-12-21T21:26:21ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2021-11-011510.3389/fnins.2021.740639740639Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without MigraineKatie M. Linstra0Katie M. Linstra1Hendrikus J. A. van Os2Ynte M. Ruigrok3Paul J. Nederkoorn4Ewoud J. van Dijk5L. Jaap Kappelle6Peter J. Koudstaal7Marieke C. Visser8Michel D. Ferrari9Antoinette MaassenVanDenBrink10Gisela M. Terwindt11Marieke J. H. Wermer12Department of Neurology, Leiden University Medical Center, Leiden, NetherlandsDivision of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Neurology, Amsterdam University Medical Center, Amsterdam, NetherlandsDepartment of Neurology, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Neurology, Erasmus Medical Center, Rotterdam, NetherlandsDepartment of Neurology, Amsterdam University Medical Center, Amsterdam, NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, NetherlandsDivision of Pharmacology and Vascular Medicine, Department of Internal Medicine, Erasmus MC, Rotterdam, NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Neurology, Leiden University Medical Center, Leiden, NetherlandsBackground: An increased risk of stroke in patients with migraine has been primarily found for women. The sex-dependent mechanisms underlying the migraine–stroke association, however, remain unknown. This study aims to explore these sex differences to improve our understanding of pathophysiological mechanisms behind the migraine–stroke association.Methods: We included 2,492 patients with ischemic stroke from the prospective multicenter Dutch Parelsnoer Institute Initiative study, 425 (17%) of whom had a history of migraine. Cardiovascular risk profile, stroke cause (TOAST classification), and outcome [modified Rankin scale (mRS) at 3 months] were compared with both sexes between patients with and without migraine.Results: A history of migraine was not associated with sex differences in the prevalence of conventional cardiovascular risk factors. Women with migraine had an increased risk of stroke at young age (onset < 50 years) compared with women without migraine (RR: 1.7; 95% CI: 1.3–2.3). Men with migraine tended to have more often stroke in the TOAST category other determined etiology (RR: 1.7; 95% CI: 1.0–2.7) in comparison with men without migraine, whereas this increase was not found in women with migraine. Stroke outcome was similar for women with or without migraine (mRS ≥ 3 RR 1.1; 95% CI 0.7–1.5), whereas men seemed to have a higher risk of poor outcome compared with their counterparts without migraine (mRS ≥ 3 RR: 1.5; 95% CI: 1.0–2.1).Conclusion: Our results indicate possible sex differences in the pathophysiology underlying the migraine–stroke association, which are unrelated to conventional cardiovascular risk factors. Further research in larger cohorts is needed to validate these findings.https://www.frontiersin.org/articles/10.3389/fnins.2021.740639/fullsex differencesmigrainestroke outcomestroke subtypecardiovascular risk factors |
| spellingShingle | Katie M. Linstra Katie M. Linstra Hendrikus J. A. van Os Ynte M. Ruigrok Paul J. Nederkoorn Ewoud J. van Dijk L. Jaap Kappelle Peter J. Koudstaal Marieke C. Visser Michel D. Ferrari Antoinette MaassenVanDenBrink Gisela M. Terwindt Marieke J. H. Wermer Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine Frontiers in Neuroscience sex differences migraine stroke outcome stroke subtype cardiovascular risk factors |
| title | Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine |
| title_full | Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine |
| title_fullStr | Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine |
| title_full_unstemmed | Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine |
| title_short | Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine |
| title_sort | sex differences in risk profile stroke cause and outcome in ischemic stroke patients with and without migraine |
| topic | sex differences migraine stroke outcome stroke subtype cardiovascular risk factors |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2021.740639/full |
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