Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine

Background: An increased risk of stroke in patients with migraine has been primarily found for women. The sex-dependent mechanisms underlying the migraine–stroke association, however, remain unknown. This study aims to explore these sex differences to improve our understanding of pathophysiological...

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Autores principales:	Katie M. Linstra, Hendrikus J. A. van Os, Ynte M. Ruigrok, Paul J. Nederkoorn, Ewoud J. van Dijk, L. Jaap Kappelle, Peter J. Koudstaal, Marieke C. Visser, Michel D. Ferrari, Antoinette MaassenVanDenBrink, Gisela M. Terwindt, Marieke J. H. Wermer
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	sex differences migraine stroke outcome stroke subtype cardiovascular risk factors Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/e56110384d3842ab83e6a29ec2a3cdf3
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spelling	oai:doaj.org-article:e56110384d3842ab83e6a29ec2a3cdf32021-11-03T16:56:26ZSex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine1662-453X10.3389/fnins.2021.740639https://doaj.org/article/e56110384d3842ab83e6a29ec2a3cdf32021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fnins.2021.740639/fullhttps://doaj.org/toc/1662-453XBackground: An increased risk of stroke in patients with migraine has been primarily found for women. The sex-dependent mechanisms underlying the migraine–stroke association, however, remain unknown. This study aims to explore these sex differences to improve our understanding of pathophysiological mechanisms behind the migraine–stroke association.Methods: We included 2,492 patients with ischemic stroke from the prospective multicenter Dutch Parelsnoer Institute Initiative study, 425 (17%) of whom had a history of migraine. Cardiovascular risk profile, stroke cause (TOAST classification), and outcome [modified Rankin scale (mRS) at 3 months] were compared with both sexes between patients with and without migraine.Results: A history of migraine was not associated with sex differences in the prevalence of conventional cardiovascular risk factors. Women with migraine had an increased risk of stroke at young age (onset < 50 years) compared with women without migraine (RR: 1.7; 95% CI: 1.3–2.3). Men with migraine tended to have more often stroke in the TOAST category other determined etiology (RR: 1.7; 95% CI: 1.0–2.7) in comparison with men without migraine, whereas this increase was not found in women with migraine. Stroke outcome was similar for women with or without migraine (mRS ≥ 3 RR 1.1; 95% CI 0.7–1.5), whereas men seemed to have a higher risk of poor outcome compared with their counterparts without migraine (mRS ≥ 3 RR: 1.5; 95% CI: 1.0–2.1).Conclusion: Our results indicate possible sex differences in the pathophysiology underlying the migraine–stroke association, which are unrelated to conventional cardiovascular risk factors. Further research in larger cohorts is needed to validate these findings.Katie M. LinstraKatie M. LinstraHendrikus J. A. van OsYnte M. RuigrokPaul J. NederkoornEwoud J. van DijkL. Jaap KappellePeter J. KoudstaalMarieke C. VisserMichel D. FerrariAntoinette MaassenVanDenBrinkGisela M. TerwindtMarieke J. H. WermerFrontiers Media S.A.articlesex differencesmigrainestroke outcomestroke subtypecardiovascular risk factorsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Neuroscience, Vol 15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	sex differences migraine stroke outcome stroke subtype cardiovascular risk factors Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	sex differences migraine stroke outcome stroke subtype cardiovascular risk factors Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Katie M. Linstra Katie M. Linstra Hendrikus J. A. van Os Ynte M. Ruigrok Paul J. Nederkoorn Ewoud J. van Dijk L. Jaap Kappelle Peter J. Koudstaal Marieke C. Visser Michel D. Ferrari Antoinette MaassenVanDenBrink Gisela M. Terwindt Marieke J. H. Wermer Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
description	Background: An increased risk of stroke in patients with migraine has been primarily found for women. The sex-dependent mechanisms underlying the migraine–stroke association, however, remain unknown. This study aims to explore these sex differences to improve our understanding of pathophysiological mechanisms behind the migraine–stroke association.Methods: We included 2,492 patients with ischemic stroke from the prospective multicenter Dutch Parelsnoer Institute Initiative study, 425 (17%) of whom had a history of migraine. Cardiovascular risk profile, stroke cause (TOAST classification), and outcome [modified Rankin scale (mRS) at 3 months] were compared with both sexes between patients with and without migraine.Results: A history of migraine was not associated with sex differences in the prevalence of conventional cardiovascular risk factors. Women with migraine had an increased risk of stroke at young age (onset < 50 years) compared with women without migraine (RR: 1.7; 95% CI: 1.3–2.3). Men with migraine tended to have more often stroke in the TOAST category other determined etiology (RR: 1.7; 95% CI: 1.0–2.7) in comparison with men without migraine, whereas this increase was not found in women with migraine. Stroke outcome was similar for women with or without migraine (mRS ≥ 3 RR 1.1; 95% CI 0.7–1.5), whereas men seemed to have a higher risk of poor outcome compared with their counterparts without migraine (mRS ≥ 3 RR: 1.5; 95% CI: 1.0–2.1).Conclusion: Our results indicate possible sex differences in the pathophysiology underlying the migraine–stroke association, which are unrelated to conventional cardiovascular risk factors. Further research in larger cohorts is needed to validate these findings.
format	article
author	Katie M. Linstra Katie M. Linstra Hendrikus J. A. van Os Ynte M. Ruigrok Paul J. Nederkoorn Ewoud J. van Dijk L. Jaap Kappelle Peter J. Koudstaal Marieke C. Visser Michel D. Ferrari Antoinette MaassenVanDenBrink Gisela M. Terwindt Marieke J. H. Wermer
author_facet	Katie M. Linstra Katie M. Linstra Hendrikus J. A. van Os Ynte M. Ruigrok Paul J. Nederkoorn Ewoud J. van Dijk L. Jaap Kappelle Peter J. Koudstaal Marieke C. Visser Michel D. Ferrari Antoinette MaassenVanDenBrink Gisela M. Terwindt Marieke J. H. Wermer
author_sort	Katie M. Linstra
title	Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
title_short	Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
title_full	Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
title_fullStr	Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
title_full_unstemmed	Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine
title_sort	sex differences in risk profile, stroke cause and outcome in ischemic stroke patients with and without migraine
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/e56110384d3842ab83e6a29ec2a3cdf3
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Sex Differences in Risk Profile, Stroke Cause and Outcome in Ischemic Stroke Patients With and Without Migraine

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