Evidence map›Paper›PMID 29593023›Full record

SynthesisBMJ open2018

Migraine and the risk of cardiovascular and cerebrovascular events: a meta-analysis of 16 cohort studies including 1 152 407 subjects.

Ahmed N Mahmoud, Amgad Mentias, Akram Y Elgendy, Abdul Qazi, Amr F Barakat, Marwan Saad, Ala Mohsen, Ahmed Abuzaid, Hend Mansoor, Mohammad K Mojadidi and 1 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
137citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

137 citing papers in PubMed, 17 syntheses or guidelines pooled it.

  1. Guideline
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  8. Is headache a risk factor for dementia? A systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
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  14. Profiling cerebrovascular function in migraine: A systematic review and meta-analysis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021
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  18. The second interim analysis of Italian participants enrolled in the real-world, Pan-European, prospective, observational, Phase 4 PEARL study of fremanezumab effectiveness.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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77 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ahmed N Mahmoud *Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.ORCID 0000-0003-2459-5195
Amgad Mentias *Department of Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Akram Y ElgendyDepartment of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
Abdul QaziDepartment of Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Amr F BarakatHeart and Vascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID 0000-0001-6859-4616
Marwan SaadDepartment of Medicine, Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Ala MohsenDepartment of Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Ahmed AbuzaidDepartment of Cardiovascular Medicine, Jefferson University Hospital/Christiana Care Health System, Newark, Delaware, USA.
Hend MansoorDepartment of Health Services Research, Management, and Policy, College of Public Health, University of Florida, Gainesville, Florida, USA.
Mohammad K MojadidiDepartment of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.
Islam Y ElgendyDepartment of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA.ORCID 0000-0001-9853-7591

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo perform an updated meta-analysis to evaluate the long-term cardiovascular and cerebrovascular outcomes among migraineurs.

settingA meta-analysis of cohort studies performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: The MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials databases were searched for relevant articles.

participantsA total of 16 cohort studies (18 study records) with 394 942 migraineurs and 757 465 non-migraineurs were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES: 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. DATA ANALYSIS: 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.

resultsMigraine was associated with a higher risk of MACCE (adjusted HR 1.42, 95% confidence interval [CI] 1.26 to 1.60, P<0.001, I

conclusionMigraine 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. PROSPERO REGISTRATION NUMBER: CRD42016052460.

Indexed as

Cardiovascular DiseasesCerebrovascular DisordersCohort StudiesComorbidityFollow-Up StudiesHumansMigraine DisordersRiskcardiac epidemiologymigrainemyocardial infarctionstroke

Identifiers

PMID29593023
PMCPMC5875642

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.