Many patients with spontaneous coronary artery dissection (SCAD), particularly those with depression and with SCAD-related chest pain, also have a history of migraine, according to a study published in the Journal of the American Heart Association.
The records of 585 participants with SCAD confirmed by coronary angiography from the Mayo Clinic SCAD “Virtual” Multi-Center Registry were reviewed, in particular, participant-provided data and records for migraine history, risk factors, SCAD details, therapies, and outcomes.
Of the 585 patients, 96% were women and 236 had a history of migraine. The rate of lifetime migraine was 40% in this cohort, and the 1-year prevalence of migraine was 26%. Migraine was more prevalent in women with SCAD vs the general population (42% vs 24%, respectively; P <.0001).
Among patients with SCAD, those with vs without a history of migraine were more likely to be women (99.6% vs 94%, respectively; P =.0002), experience SCAD at a younger age (45.2±9.0 years vs 47.6±9.9 years, respectively; P =.0027), have depression (27% vs 17%, respectively; P =.025), have recurrent post-SCAD chest pain at 1 month (50% vs 39%, respectively; P =.035), and have aneurysms, pseudoaneurysms, or dissections (28% vs 18%, respectively; P =.018). The prevalence of recurrent SCAD at 5 years was comparable in patients with vs without migraine (15% vs 19%, respectively; P =.39).
“As SCAD research continues, further investigation into this newly characterized association between migraine and SCAD may significantly impact our understanding of mechanisms of disease and clinical management decisions, particularly related to systemic vascular abnormalities, recurrent angina, mood disorders, and migraine medications,” the researchers noted.
Kok SN, Hayes SN, Cutrer M, et al. Prevalence and clinical factors of migraine in patients with spontaneous coronary artery dissection [published online December 13, 2018]. J Am Heart Assoc. doi: 10.1161/JAHA.118.010140