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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Annual Meeting of the American Academy of Neurology |
Chicago, IL April 15-18, 2008 |
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Mutation Quadruples Stroke Risk in
Patients who have Migraine with Aura |
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BY DON SCHRADER
Contributing Writer |
CHICAGO
(ECCC)— A mutation in a gene involved in folate
production affords modest protection against migraine with aura,
but magnifies the association between migraine with aura and
cardiovascular disease, according to data from the Women’s
Health Study (WHS) reported on April 17 during the annual
meeting of the American Academy of Neurology.
The methylenetetrahydrofolate reductase (MTHFR) 677TT genotype
reduced the risk of migraine with aura by about 20%. However,
the combination of that genotype and a history of migraine with
aura almost quadrupled the risk of cardiovascular disease,
particularly ischemic stroke.
“The effect of migraine with aura and the TT genotype appears
limited to ischemic stroke and does not seem to increase the
risk of myocardial infarction,” said Dr. Markus Schuerks of
Harvard Medical School. “The mechanisms by which the TT genotype
increases the risk should be examined in future studies.”
Epidemiologic studies have demonstrated an association between
migraine with aura and cardiovascular disease (CVD). The
association might involve the MTHFR 677C>T polymorphism, which
has a controversial link to both conditions, said Dr. Schuerks.
About 10% of the U.S. population is homozygous for the
polymorphism (MTHFR 677TT), including a comparable proportion of
WHS population.
The investigators analyzed data on 25,001 participants in the
WHS. Migraine status, including aura, was self-reported, and CVD
was confirmed by a review of medical records.
At baseline, 4,577 (18.3%) women reported a history of migraine,
including 3,266 who had active migraine status. About 40% of the
women with active migraine reported aura.
During an average follow-up of 11.9 years, there were a total of
649 CVD events. In a multivariate analysis, the MTHFR 677TT
genotype was associated with a relative risk of 0.79 of migraine
with aura, or a 21% risk reduction. The TT genotype did not
increase the risk of CVD events compared with other genotypes.
However, migraine with aura doubled the risk of CVD events (RR
2.09, P<0.0001).
Among WHS participants who had migraine with aura, the TT
genotype increased the relative risk of CVD events to 3.66
(P=0.001). The overall impact was driven by a relative risk of
4.19 for ischemic stroke (P=0.01), as the TT genotype did not
increase the risk of myocardial infarction in patients who had
migraine with aura. |
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