Folsom Aaron R, Lutsey Pamela L, Misialek Jeffrey R, Cushman Mary
Division of Epidemiology & Community Health School of Public Health University of Minnesota Minneapolis Minnesota.
Department of Medicine University of Vermont Burlington Vermont.
Res Pract Thromb Haemost. 2019 Apr 3;3(3):357-363. doi: 10.1002/rth2.12200. eCollection 2019 Jul.
Limited evidence suggests that migraine might be a risk factor for venous thromboembolism (VTE). We conducted an epidemiologic study to assess whether migraine history is associated prospectively with VTE or cross sectionally with hemostatic risk markers for VTE.
In a population-based US cohort, 11 985 participants free of VTE reported headache symptoms in 1993-1995. We classified participants as having either migraines with or without aura, severe nonmigraine headaches, or no severe headaches. We followed them through 2015 for incident VTE verified by medical records.
Participants' mean age at baseline was 60 years (SD: 6). Eleven percent were classified as having a migraine history (932 without aura and 396 with aura). Over a mean of 18 years and 211 913 person-years at risk, 688 participants developed VTE. Participants with a migraine history had no greater risk of VTE compared with those free of severe headache (adjusted hazard ratio [HR]: 1.06, 95% confidence interval [CI]: 0.82-1.36). Those with migraine history with aura had an HR of 1.25 (95% CI: 0.85-1.85). Self-reported physician diagnosis of migraine carried an HR of 1.22 (0.96-1.55). At baseline, those with a history of migraine, furthermore, did not have a higher frequency of elevated hemostatic risk factors or a higher genetic risk score for VTE.
This study does not support the hypothesis that migraine history is an important risk factor for VTE in older adults.
有限的证据表明偏头痛可能是静脉血栓栓塞症（VTE）的一个风险因素。我们进行了一项流行病学研究，以评估偏头痛病史是否与VTE存在前瞻性关联，或与VTE的止血风险标志物存在横断面关联。
在美国一项基于人群的队列研究中，11985名无VTE的参与者在1993 - 1995年报告了头痛症状。我们将参与者分为有先兆或无先兆偏头痛、严重非偏头痛性头痛或无严重头痛。通过医疗记录对他们进行随访至2015年，以确定VTE事件。
参与者基线时的平均年龄为60岁（标准差：6）。11%的人被归类为有偏头痛病史（932人无先兆，396人有先兆）。在平均18年和211913人年的风险期内，688名参与者发生了VTE。有偏头痛病史的参与者与无严重头痛的参与者相比，发生VTE的风险并无增加（调整后的风险比[HR]：1.06，95%置信区间[CI]：0.82 - 1.36）。有先兆偏头痛病史的参与者HR为1.25（95%CI：0.85 - 1.85）。自我报告的医生诊断偏头痛的HR为1.22（0.96 - 1.55）。此外，在基线时，有偏头痛病史的人并没有更高频率的止血风险因素升高或更高的VTE遗传风险评分。
本研究不支持偏头痛病史是老年人VTE重要风险因素这一假设。
