Evidence map›Paper›PMID 40545732›Full record

ArticleHeadache

Cardiovascular risk and triptan usage among patients with migraine.

Ido Peles, Ruth Smadar Shneyour, Eran Levanon, Yana Mechnik Steen, Ibraheem Abu Salameh, Michal Gordon, Ran Abuhasira, Victor Novack, Gal Ifergane

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Headache. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

  1. Review
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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

9 authors.

Ido PelesFaculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.ORCID 0000-0001-8772-1780
Ruth Smadar ShneyourFaculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Eran LevanonFaculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Yana Mechnik SteenBrain Medicine Division, Department of Neurology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Ibraheem Abu SalamehBrain Medicine Division, Department of Neurology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Michal GordonClinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Ran AbuhasiraFaculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Victor NovackFaculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
Gal IferganeBrain Medicine Division, Department of Neurology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.

Funding

Pfizer, Israel
6 · The paper itself

Abstract

backgroundMigraine, a neurovascular disorder evident by recurrent headaches, is associated with increased risk of ischemic vascular events, including ischemic stroke and myocardial infarction. Triptans, acute migraine-specific treatment, cause vasoconstriction, complicating treatment decisions, especially for patients with migraine with cardiovascular risk factors. This study examined associations between triptan usage and cardiovascular (CV) events in patients with migraine.

methodsThis retrospective, population-based cohort study conducted in southern Israel utilized data from Clalit Health Services. Electronic medical records from January 2000 to January 2022 were analyzed to assess triptan usage and CV events within 90 days post-purchase among patients aged ≥18 years with a diagnosis of migraine based on International Classification of Diseases, Ninth Revision codes or triptan claims. Sensitivity analyses accounted for varying timeframes and usage patterns.

resultsAmong 26,054 patients with migraine, 12,560 (48.2%) initiated triptan therapy. The prevalence of CV risk factors including dyslipidemia, diabetes mellitus, hypertension, smoking, atrial fibrillation, and obesity was higher in the non-triptan group (standardized mean difference [SMD] = 0.028-0.289). The mean (standard deviation) number of triptan pills used per month was 1.9 (1.5), with most patients (89.5%) using 1-4 pills/month. CV events within 90 days occurred slightly more in the triptan group (5.1%) compared to the non-triptan group (4.1%, SMD = 0.047). Multivariable analysis revealed no significant association between triptan use and increased CV events (adjusted hazard ratio 0.96, 95% confidence interval 0.77-1.23), controlling for demographic variables and CV risk factors. Sensitivity analyses also showed no significant risk with triptan use across different timeframes and usage patterns, reinforcing these findings. In the triptan group, patients with CV events were more likely to use triptans frequently, with a higher average number of pills per month.

conclusionsThis retrospective, population-based study found that triptan usage did not increase CV risk among patients with migraine, even in those with existing CV risk factors, where no formal contraindication exists. The study highlights the importance of considering individual risk factors when prescribing triptans, as certain subgroups may still be at higher risk.

Indexed as

Cardiovascular DiseasesHeart Disease Risk FactorsMigraine DisordersTryptaminesAdultAgedFemaleHumansIsraelMaleMiddle AgedRetrospective StudiesYoung AdultTryptaminescardiovascular risk factorsischemic strokeischemic vascular eventsmigrainemyocardial infarctiontriptans

Identifiers

PMID40545732
PMCPMC12266636

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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.