Increased risk of ischemic heart disease in young patients with migraine: a population-based, propensity score-matched, longitudinal follow-up study

Background: The association between migraine and the risk of ischemic heart disease (IHD) remains controversial. The purpose of the present population-based, propensity score-matched follow-up study was to investigate whether young migraineurs are at a higher risk of developing IHD.

Methods: A total of 11,541 subjects aged between 18 and 45 years with at least two ambulatory visits with the principal diagnosis of migraine in 2001 were enrolled in the migraine group. We used a logistic regression model that included age, sex, pre-existing comorbidities, and socioeconomic status as covariates to compute the propensity score. The non-migraine group consisted of 11,541 propensity score-matched, randomly sampled subjects without migraine. The 3-year IHD-free survival rate and the cumulative incidence of IHD were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression with patients matched by propensity score was used to estimate the effect of migraine on the risk of developing subsequent IHD.

Results: The mean age in both groups was 32.3 years. During follow-up, 121 subjects in the migraine group and 55 in the non-migraine group developed IHD. The incidence rate of IHD was 4.56 (95% confidence interval [CI], 3.78 to 5.44) per 1000 person-years in the migraine group and 2.00 (95% CI, 1.51 to 2.61) per 1000 person-years in the non-migraine group. Compared to the non-migraine group, the HR of IHD for the migraine group was 2.50 (95% CI, 1.78 to 3.52, P<0.0001).

Conclusions: This study showed an increased risk of developing IHD in young patients with newly diagnosed migraine.