Contribution of Migraine to Cardiovascular Disease Risk Prediction
Migraine with aura (MA) is associated with cardiovascular disease (CVD) independently from traditional vascular risk factors. However, the importance of MA on CVD occurrence relative to existing cardiovascular prediction tools remains unclear. In this study, we sought to determine if adding MA statu...
Gespeichert in:
| Veröffentlicht in: | Journal of the American College of Cardiology Jg. 81; H. 23; S. 2246 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
United States
13.06.2023
|
| Schlagworte: | |
| ISSN: | 1558-3597, 1558-3597 |
| Online-Zugang: | Weitere Angaben |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Abstract | Migraine with aura (MA) is associated with cardiovascular disease (CVD) independently from traditional vascular risk factors. However, the importance of MA on CVD occurrence relative to existing cardiovascular prediction tools remains unclear.
In this study, we sought to determine if adding MA status to 2 CVD risk prediction models improves risk prediction.
Participants enrolled in the Women's Health Study self-reported MA status and were followed for incident CVD events. We included MA status as a covariable in the Reynolds Risk Score and the American Heart Association (AHA)/American College of Cardiology (ACC) pooled cohort equation and assessed discrimination (Harrell c-index), continuous and categorical net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
MA status was significantly associated with CVD after including covariables in the Reynolds Risk Score (HR: 2.09; 95% CI: 1.54-2.84) and the AHA/ACC score (HR: 2.10; 95% CI: 1.55-2.85). Adding information on MA status improved discrimination of the Reynolds Risk Score model (from 0.792 to 0.797; P = 0.02) and the AHA/ACC score model (from 0.793 to 0.798; P = 0.01). We observed a small but statistically significant improvement in the IDI and continuous NRI after adding MA status to both models. We did not, however, observe significant improvements in the categorical NRI.
Adding information on MA status to commonly used CVD risk prediction algorithms enhanced model fit but did not substantially improve risk stratification among women. Despite the strong association of migraine with CVD risk, the relatively low prevalence of MA compared with other CV risk factors limits its usefulness in improving risk classification at the population level. |
|---|---|
| AbstractList | Migraine with aura (MA) is associated with cardiovascular disease (CVD) independently from traditional vascular risk factors. However, the importance of MA on CVD occurrence relative to existing cardiovascular prediction tools remains unclear.
In this study, we sought to determine if adding MA status to 2 CVD risk prediction models improves risk prediction.
Participants enrolled in the Women's Health Study self-reported MA status and were followed for incident CVD events. We included MA status as a covariable in the Reynolds Risk Score and the American Heart Association (AHA)/American College of Cardiology (ACC) pooled cohort equation and assessed discrimination (Harrell c-index), continuous and categorical net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
MA status was significantly associated with CVD after including covariables in the Reynolds Risk Score (HR: 2.09; 95% CI: 1.54-2.84) and the AHA/ACC score (HR: 2.10; 95% CI: 1.55-2.85). Adding information on MA status improved discrimination of the Reynolds Risk Score model (from 0.792 to 0.797; P = 0.02) and the AHA/ACC score model (from 0.793 to 0.798; P = 0.01). We observed a small but statistically significant improvement in the IDI and continuous NRI after adding MA status to both models. We did not, however, observe significant improvements in the categorical NRI.
Adding information on MA status to commonly used CVD risk prediction algorithms enhanced model fit but did not substantially improve risk stratification among women. Despite the strong association of migraine with CVD risk, the relatively low prevalence of MA compared with other CV risk factors limits its usefulness in improving risk classification at the population level. Migraine with aura (MA) is associated with cardiovascular disease (CVD) independently from traditional vascular risk factors. However, the importance of MA on CVD occurrence relative to existing cardiovascular prediction tools remains unclear.BACKGROUNDMigraine with aura (MA) is associated with cardiovascular disease (CVD) independently from traditional vascular risk factors. However, the importance of MA on CVD occurrence relative to existing cardiovascular prediction tools remains unclear.In this study, we sought to determine if adding MA status to 2 CVD risk prediction models improves risk prediction.OBJECTIVESIn this study, we sought to determine if adding MA status to 2 CVD risk prediction models improves risk prediction.Participants enrolled in the Women's Health Study self-reported MA status and were followed for incident CVD events. We included MA status as a covariable in the Reynolds Risk Score and the American Heart Association (AHA)/American College of Cardiology (ACC) pooled cohort equation and assessed discrimination (Harrell c-index), continuous and categorical net reclassification improvement (NRI), and integrated discrimination improvement (IDI).METHODSParticipants enrolled in the Women's Health Study self-reported MA status and were followed for incident CVD events. We included MA status as a covariable in the Reynolds Risk Score and the American Heart Association (AHA)/American College of Cardiology (ACC) pooled cohort equation and assessed discrimination (Harrell c-index), continuous and categorical net reclassification improvement (NRI), and integrated discrimination improvement (IDI).MA status was significantly associated with CVD after including covariables in the Reynolds Risk Score (HR: 2.09; 95% CI: 1.54-2.84) and the AHA/ACC score (HR: 2.10; 95% CI: 1.55-2.85). Adding information on MA status improved discrimination of the Reynolds Risk Score model (from 0.792 to 0.797; P = 0.02) and the AHA/ACC score model (from 0.793 to 0.798; P = 0.01). We observed a small but statistically significant improvement in the IDI and continuous NRI after adding MA status to both models. We did not, however, observe significant improvements in the categorical NRI.RESULTSMA status was significantly associated with CVD after including covariables in the Reynolds Risk Score (HR: 2.09; 95% CI: 1.54-2.84) and the AHA/ACC score (HR: 2.10; 95% CI: 1.55-2.85). Adding information on MA status improved discrimination of the Reynolds Risk Score model (from 0.792 to 0.797; P = 0.02) and the AHA/ACC score model (from 0.793 to 0.798; P = 0.01). We observed a small but statistically significant improvement in the IDI and continuous NRI after adding MA status to both models. We did not, however, observe significant improvements in the categorical NRI.Adding information on MA status to commonly used CVD risk prediction algorithms enhanced model fit but did not substantially improve risk stratification among women. Despite the strong association of migraine with CVD risk, the relatively low prevalence of MA compared with other CV risk factors limits its usefulness in improving risk classification at the population level.CONCLUSIONSAdding information on MA status to commonly used CVD risk prediction algorithms enhanced model fit but did not substantially improve risk stratification among women. Despite the strong association of migraine with CVD risk, the relatively low prevalence of MA compared with other CV risk factors limits its usefulness in improving risk classification at the population level. |
| Author | Cook, Nancy R Buring, Julie E Rist, Pamela M Kurth, Tobias |
| Author_xml | – sequence: 1 givenname: Pamela M surname: Rist fullname: Rist, Pamela M email: prist@mail.harvard.edu organization: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address: prist@mail.harvard.edu – sequence: 2 givenname: Julie E surname: Buring fullname: Buring, Julie E organization: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA – sequence: 3 givenname: Nancy R surname: Cook fullname: Cook, Nancy R organization: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA – sequence: 4 givenname: Tobias surname: Kurth fullname: Kurth, Tobias organization: Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37286254$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNj0tLxDAcxIOsuA_9Ah4kRy-teTVNjtr1BSuK6Lkk6b-StdusSSv47V1xBU8zh9_MMHM06UMPCJ1SklNC5cU6XxvnckYYzwnPBdMHaEaLQmW80OXkn5-ieUprQohUVB-hKS-ZkqwQM3RVhX6I3o6DDz0OLX7wb9H4HvAQcGVi48OnSW7sTMRLn8AkwM8-veOnCI13P6ljdNiaLsHJXhfo9eb6pbrLVo-399XlKnNCsiFrlJWKWeoMACXNbr-kpQQuraBgRQvUcOmIUAIUMaA0c0RTaK0w1FLC2AKd__ZuY_gYIQ31xicHXWd6CGOqmWJca1pouUPP9uhoN9DU2-g3Jn7Vf7_ZN_ZMXK8 |
| CitedBy_id | crossref_primary_10_2147_JPR_S512795 crossref_primary_10_1186_s10194_025_01998_1 crossref_primary_10_1016_j_jns_2024_123367 crossref_primary_10_1080_01616412_2025_2456708 crossref_primary_10_1038_s41569_023_00934_7 crossref_primary_10_1111_head_14936 crossref_primary_10_1186_s43162_024_00367_9 crossref_primary_10_1016_j_jacc_2023_04_012 crossref_primary_10_1016_j_jad_2025_03_169 crossref_primary_10_1001_jamanetworkopen_2024_40577 crossref_primary_10_1080_1028415X_2024_2338343 crossref_primary_10_3390_app132312960 crossref_primary_10_1186_s10194_024_01836_w crossref_primary_10_1007_s40122_024_00626_1 crossref_primary_10_1016_j_ijcrp_2025_200483 |
| ContentType | Journal Article |
| Copyright | Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
| Copyright_xml | – notice: Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
| DBID | NPM 7X8 |
| DOI | 10.1016/j.jacc.2023.03.429 |
| DatabaseName | PubMed MEDLINE - Academic |
| DatabaseTitle | PubMed MEDLINE - Academic |
| DatabaseTitleList | PubMed MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1558-3597 |
| ExternalDocumentID | 37286254 |
| Genre | Journal Article |
| GroupedDBID | --- --K --M .1- .FO .~1 0R~ 18M 1B1 1P~ 1~. 1~5 2WC 4.4 457 4G. 53G 5GY 5RE 5VS 6PF 7-5 71M 8P~ AABNK AABVL AACTN AAEDT AAEDW AAIKJ AAKUH AALRI AAOAW AAQFI AAQQT AAXUO ABBQC ABFNM ABFRF ABLJU ABMAC ABMZM ABOCM ACGFO ACGFS ACIUM ACJTP ACPRK ADBBV ADEZE ADVLN AEFWE AEKER AENEX AEVXI AEXQZ AFCTW AFETI AFRAH AFRHN AFTJW AGYEJ AHMBA AITUG AJRQY AKRWK ALMA_UNASSIGNED_HOLDINGS AMRAJ BAWUL BLXMC CS3 DIK DU5 E3Z EBS EO8 EO9 EP2 EP3 F5P FDB FEDTE FNPLU G-Q GBLVA GX1 HVGLF IHE IXB J1W K-O KQ8 L7B MO0 N9A NPM O-L O9- OA. OAUVE OK1 OL~ OZT P-8 P-9 P2P PC. PQQKQ Q38 ROL RPZ SCC SDF SDG SDP SES SSZ TR2 UNMZH UV1 W8F WH7 WOQ WOW YYM YZZ Z5R 7X8 ACVFH ADCNI AEUPX AFPUW AIGII AKBMS AKYEP EFKBS ~HD |
| ID | FETCH-LOGICAL-c462t-d8b682b1caee10d8627176e36b41eb4fe1a36c0484e80ae892c091efb4a1b1022 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 16 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001015097300001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1558-3597 |
| IngestDate | Sun Sep 28 01:57:59 EDT 2025 Thu Apr 03 07:07:30 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 23 |
| Keywords | cardiovascular disease risk prediction migraine |
| Language | English |
| License | Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c462t-d8b682b1caee10d8627176e36b41eb4fe1a36c0484e80ae892c091efb4a1b1022 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PMID | 37286254 |
| PQID | 2823991596 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2823991596 pubmed_primary_37286254 |
| PublicationCentury | 2000 |
| PublicationDate | 2023-06-13 |
| PublicationDateYYYYMMDD | 2023-06-13 |
| PublicationDate_xml | – month: 06 year: 2023 text: 2023-06-13 day: 13 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | Journal of the American College of Cardiology |
| PublicationTitleAlternate | J Am Coll Cardiol |
| PublicationYear | 2023 |
| SSID | ssj0006819 |
| Score | 2.5034788 |
| Snippet | Migraine with aura (MA) is associated with cardiovascular disease (CVD) independently from traditional vascular risk factors. However, the importance of MA on... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 2246 |
| Title | Contribution of Migraine to Cardiovascular Disease Risk Prediction |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/37286254 https://www.proquest.com/docview/2823991596 |
| Volume | 81 |
| WOSCitedRecordID | wos001015097300001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT8MwDLaAIcSF92O8FCSuFW0TsuSEeE0c2DQhQLtVaeKigdSOdfD7cdpOExeExCW3RJHjxJ_jzzbAmUSZaaPSQDufkmMxDHQoaSDsrMmgoq7ImC8PnX5fDYd60Hy4lQ2tcvYmVg-1K6z_Iz8n14BsKRlfeTn-CHzXKB9dbVpoLEKLE5TxlK7OcF4tXKqqsQeZTBVwQs5N0kzN73oz1pcwjLkvcip-g5iVqemu_3eTG7DWgEx2VWvFJixgvgUrvSaMvg3XvibVrNMVKzLWG736VhHIpgW7-cFQZbd1BIc9jsp3Npj4NfysHXju3j3d3AdNM4XAChlPA6dSqeI0sgYxCh05MuTISeQyFRGmIsPIcGnpPgtUoUGlY0uHhVkqTJR6t3AXlvIix31gxsisSvnlzhHe00a4jIQpldXcWufacDqTTkLK6iMQJsfis0zm8mnDXi3iZFxX1Uh4J6ZNXYiDP8w-hFV_cp6yFfEjaGV0VfEYlu3XdFROTiotoLE_6H0Da9q77A |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Contribution+of+Migraine+to+Cardiovascular+Disease+Risk+Prediction&rft.jtitle=Journal+of+the+American+College+of+Cardiology&rft.au=Rist%2C+Pamela+M&rft.au=Buring%2C+Julie+E&rft.au=Cook%2C+Nancy+R&rft.au=Kurth%2C+Tobias&rft.date=2023-06-13&rft.issn=1558-3597&rft.eissn=1558-3597&rft.volume=81&rft.issue=23&rft.spage=2246&rft_id=info:doi/10.1016%2Fj.jacc.2023.03.429&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1558-3597&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1558-3597&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1558-3597&client=summon |