Risk of AFib Increased in Patients With Migraine

November 26, 2018

Migraine with visual aura has been associated with increased cardioembolic stroke risk; authors of a recent study sought to test whether there may be an association with atrial fibrillation (AF) as well.

According to Souvik Sen, MD, MS, MPH, University of South Carolina, School of Medicine (Columbia, SC) and colleagues, “Since [AF] is a common source of cardioembolic stroke, the question that begs to be answered is whether the association between migraine with visual aura and cardioembolic stroke may be explained by a higher rate of atrial fibrillation” (November 19, 2018. Healio).

In the Atherosclerosis Risk in Communities study, a longitudinal, community-based cohort study, participants were interviewed for migraine history in 1993-1995 and were followed for incident AF through 2013.

Researchers in the present study analyzed electrocardiograms, discharge codes and death certificate data from 11,939 participants of that study who did not have a prior history of stroke or AF.

Over a 20-year follow-up period, 426 patients reported migraines with visual aura; 1018 reported nonmigraine headache; 1090 reported migraine without visual aura; and 9405 reported no headache. Incident AF was noted in 15% of patients with migraine and 17% of patients without headache. 

After adjusting for patient comorbidities and demographics, migraine with visual aura was associated with increased risk for AF vs no headache (HR = 1.3; 95% CI, 1.03-1.62) and when compared to migraine without visual aura (HR = 1.39; 95% CI, 1.05-1.83).

“This finding has important clinical implications and may help us better understand the atrial fibrillation mediation of the migraine-stroke link. A randomized clinical trial may help ascertain whether patients with migraine with visual aura may benefit from atrial fibrillation detection and subsequent anticoagulation or antiplatelet therapy as a primary stroke prevention strategy,” authors noted.

This report is one of the first of its kind on migraine-AF association in the United States.

—Amanda Del Signore

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