Evidence map›Paper›PMID 41676929›Full record

Observational studyJournal of the American Heart Association2026

Triptan Initiation and Cerebrovascular Events in Patients With Migraine: A Nationwide Cohort Study.

Cheryl Kalapura, Jay B Lusk, Lauren E Wilson, Carlene Moore, Stephanie Yarnell, Aparna Choudhury, Matthew Schrag, Sven Poli, Nosayaba Osazuwa-Peters, Emily O'Brien and 4 more

Abstract readObservational Study
In one paragraph

Observational study in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Cheryl Kalapura *Duke University School of Medicine Durham NC USA.ORCID 0009-0007-5770-2088
Jay B Lusk *Department of Family Medicine University of North Carolina Chapel Hill Chapel Hill NC USA.ORCID 0000-0002-5728-8872
Lauren E WilsonORBIT Interdisciplinary Hub, Duke Clinical Research Institute Duke University Durham NC USA.ORCID 0000-0002-5953-2293
Carlene MooreDepartment of Neurology Duke University School of Medicine Durham NC USA.ORCID 0000-0002-1468-6408
Stephanie YarnellDepartment of Psychiatry Yale University School of Medicine New Haven CT USA.
Aparna ChoudhuryDepartment of Neurology Duke University School of Medicine Durham NC USA.
Matthew SchragDepartment of Neurology Vanderbilt University School of Medicine Nashville TN USA.ORCID 0000-0001-7048-0503
Sven PoliDepartment of Neurology & Stroke University of Tübingen Tübingen Germany.ORCID 0000-0002-0286-8781
Nosayaba Osazuwa-PetersORBIT Interdisciplinary Hub, Duke Clinical Research Institute Duke University Durham NC USA.
Emily O'BrienORBIT Interdisciplinary Hub, Duke Clinical Research Institute Duke University Durham NC USA.ORCID 0000-0002-8257-7561
Eric D PetersonDepartment of Medicine UT Southwestern Medical Center Dallas TX USA.ORCID 0000-0002-5415-4721
Ying XianDepartment of Medicine UT Southwestern Medical Center Dallas TX USA.ORCID 0000-0002-1237-1162
Fan LiORBIT Interdisciplinary Hub, Duke Clinical Research Institute Duke University Durham NC USA.ORCID 0000-0002-0390-3673
Brian Mac GroryORBIT Interdisciplinary Hub, Duke Clinical Research Institute Duke University Durham NC USA.ORCID 0000-0003-3914-8419

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTriptan medications are proposed as an association of cerebral ischemic stroke in patients with migraine, but population-based data on this are lacking.

methodsA retrospective, observational, cohort study was performed using computerized claims data from a proprietary, insurance-based registry-Marketscan (by Merative). Patients with at least 1 claim related to a migraine diagnosis were included. The primary exposure was initiation of any triptan medication defined by at least 1 prescription fill. The primary end point was time to cerebral ischemic stroke. Secondary end points included time to retinal stroke (central retinal artery occlusion, other retinal artery occlusion), intracranial hemorrhage, and myocardial infarction. The association between triptan initiation and study end points was modeled using a propensity score-overlap weighted Cox model. Adjusted hazard ratios (HR) and corresponding 95% CIs were computed.

resultsIn total, 869 092 patients (median age 40.0 years [Q1-Q3, 30.0-50.0]; 77.5% female) met study selection criteria of whom 287 629 initiated a triptan and 581 463 did not. Median follow-up was 2555 days in the entire cohort. Initiation of a triptan was associated with higher hazard of cerebral ischemic stroke (adjusted HR, 2.37 [95% CI, 1.65-3.51]; absolute risk difference of 0.17% per year). Of 4 secondary end points, 2 were associated with triptan use: intracranial hemorrhage (adjusted HR, 2.37 [95% CI, 1.65-3.41]) and myocardial infarction (adjusted HR, 2.06 [95% CI, 1.60-2.66]).

conclusionsIn a population-based cohort study, initiation of a triptan was independently associated with risk of subsequent cerebral ischemic stroke.

Indexed as

Ischemic StrokeMigraine DisordersStrokeTryptaminesAdultFemaleHumansIntracranial HemorrhagesMaleMiddle AgedMyocardial InfarctionPropensity ScoreProportional Hazards ModelsRegistriesRetrospective StudiesRisk FactorsTryptaminescerebrovascular diseaseintracranial hemorrhagemigrainestroketriptan

Identifiers

PMID41676929
PMCPMC13055840

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Registered trials

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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.