Identifying Risk factors for Major Adverse Cardiovascular Events (MACE) in Patients with Migraine: A Logistic Regression Analysis of Demographics, Comorbidities, and Brain Imaging Findings
Abstract Body: Background: Prior studies indicate a relationship between migraine and MACE. Here we assess whether brain white matter hyperintensities (WMH), which are a common imaging finding in patient with migraine, contribute to the risk of MACE above demographics and common risk factors for MACE. Methods: 60,454 patients, ages 18-89, with a ICD-9 or ICD-10 migraine diagnosis code in 2010 or later were identified from the Mayo Clinic electronic health record. Only patients who were seen for migraine in the Neurology Department were included. Patients with a migraine diagnosis who did not have MACE were included only if they had at least two visits at Mayo Clinic during five years. Only patients with sex and race information were included. The final cohort included 577 migraine patients with and 598 migraine patients without MACE. Presence of WMH was determined from radiology notes. Individuals without a brain MRI were assumed not to have WMH. A logistic regression model that included sex, race, known lifetime MACE risk factors (atrial fibrillation, diabetes, hypertension, hyperlipidemia, tobacco use) and WMH as independent variables to predict MACE outcome was fit. Results: Significant factors that increased the risk of MACE in individuals with migraine included being Black or African American (adjusted OR: 2.9, 95% CI: 1.24-6.82, p = 0.014), presence of atrial fibrillation (adj. OR: 1.63, 95% CI: 1.23-2.17, p < 0.001), diabetes (adj. OR: 1.34, 95% CI: 1.02-1.75, p = 0.036), hypertension (adj. OR: 1.9, 95% CI: 1.39-2.6, p < 0.001), tobacco use (adj. OR: 1.66, 95% CI: 1.29-2.14, p < 0.001), and the presence of WMH (adj. OR: 1.43, 95% CI: 1.1-1.87, p = 0.008). Hyperlipidemia showed a marginal association (adj. OR: 1.34, 95% CI: 0.99-1.81, p = 0.061), while other variables such as sex and other racial/ethnic groups did not significantly alter the risk of MACE outcome. Discussion: Results indicate that African American race and presence of WMH in addition to common comorbidities independently increase the risk of MACE outcome.
Dumkrieger, Gina
( Mayo Clinic
, Tempe
, Arizona
, United States
)
Dumitrascu, Oana
( Mayo Clinic
, Scottsdale
, Arizona
, United States
)
Tariq, Amara
( Mayo Clinic, AZ
, Phoenix
, Arizona
, United States
)
Banerjee, Imon
( Mayo Clinic
, Phoenix
, Arizona
, United States
)
Schwedt, Todd
( Mayo Clinic
, Scottsdale
, Arizona
, United States
)
Chong, Catherine
( Mayo Clinic
, Cave creek
, Arizona
, United States
)
Author Disclosures:
Gina Dumkrieger:DO NOT have relevant financial relationships
| Oana Dumitrascu:DO NOT have relevant financial relationships
| Amara Tariq:DO NOT have relevant financial relationships
| Imon Banerjee:DO NOT have relevant financial relationships
| Todd Schwedt:DO have relevant financial relationships
;
Consultant:AbbVie:Active (exists now)
; Royalties/Patent Beneficiary:UpToDate:Active (exists now)
; Research Funding (PI or named investigator):Pfizer:Active (exists now)
; Individual Stocks/Stock Options:Nocira:Active (exists now)
; Individual Stocks/Stock Options:Aural Analytics:Past (completed)
; Consultant:Scilex:Past (completed)
; Consultant:Salvia:Active (exists now)
; Consultant:Lundbeck:Active (exists now)
; Consultant:Linpharma:Past (completed)
; Consultant:Amgen:Past (completed)
; Consultant:Allergan:Past (completed)
| Catherine Chong:DO NOT have relevant financial relationships
Xu Xiaohong, Preeti Preeti, Yu Ruoying, Shaykhalishahi Hamed, Zhang Cheng, Shen Chuanbin, Li Bei, Tang Naping, Chang Yan, Xiang Qian, Cui Yimin, Lei Xi, Ni Heyu, Zhu Guangheng, Liu Zhenze, Hu Xudong, Slavkovic Sladjana, Neves Miguel, Ma Wenjing, Xie Huifang
