Department of Neurology, People's Hospital of Liaoning Province, People's Hospital of China Medical University, Shenyang, China.
Department of Neurology, Baoji Central Hospital, Baoji, China.
Behav Neurol. 2022 Mar 20;2022:2118740. doi: 10.1155/2022/2118740. eCollection 2022.
There have been speculation and research linking migraine with abnormalities of platelet aggregation and activation. The role of the P2Y12 platelet inhibitor in the treatment of migraine has not been established. We aim to evaluate the efficacy of the platelet P2Y12 inhibitor in the treatment of migraine and prevention of new-onset migraine headache (MHA) following transcatheter atrial septal defect closure (ASDC). We searched the PubMed, Web of Science, and Cochrane Library databases for relevant studies. The primary outcomes were the headache responder rate and the rate of new-onset migraine attacks following ASDC. Four studies for a total of 262 migraine patients with or without patent foramen ovale (PFO) and three studies involving 539 patients with antiplatelet treatment in the prevention of new-onset migraine following ASDC were included. The pooled responder rate of the P2Y12 inhibitor for migraine was 0.64 (95% CI: 0.43 to 0.81). For patients who underwent ASDC, the use of antiplatelet regimens including the P2Y12 inhibitor, compared with regimens excluding P2Y12 inhibitor, resulted in a lower rate of new-onset migraine (OR: 0.41, 95% CI: 0.22 to 0.77, = 0.005). We concluded that the P2Y12 platelet inhibitor may have a primary prophylactic role in migraine patients with or without PFO and prevent new-onset MHA after ASDC. The responsiveness of the P2Y12 inhibitor could help select candidates who would benefit from PFO closure. It warrants further large-scale research to explore the role of the P2Y12 inhibitor, particularly in a proportion of migraine patients.
有推测和研究将偏头痛与血小板聚集和激活异常联系起来。P2Y12 血小板抑制剂在偏头痛治疗中的作用尚未确定。我们旨在评估血小板 P2Y12 抑制剂在治疗偏头痛和预防经导管房间隔缺损封堵（ASDC）后新发偏头痛头痛（MHA）中的疗效。我们在 PubMed、Web of Science 和 Cochrane Library 数据库中搜索了相关研究。主要结局是 ASDC 后头痛缓解率和新发偏头痛发作率。共有 4 项研究共纳入 262 例偏头痛患者（有或无卵圆孔未闭），3 项研究共纳入 539 例抗血小板治疗预防 ASDC 后新发偏头痛的患者。P2Y12 抑制剂治疗偏头痛的缓解率为 0.64（95%CI：0.43 至 0.81）。对于接受 ASDC 的患者，与不包括 P2Y12 抑制剂的方案相比，包括 P2Y12 抑制剂的抗血小板方案导致新发偏头痛的发生率较低（OR：0.41，95%CI：0.22 至 0.77， = 0.005）。我们得出结论，P2Y12 血小板抑制剂在有或无卵圆孔未闭的偏头痛患者中可能具有主要的预防性作用，并可预防 ASDC 后新发偏头痛。P2Y12 抑制剂的反应性可能有助于选择受益于卵圆孔未闭封堵的患者。需要进一步的大规模研究来探索 P2Y12 抑制剂的作用，特别是在一部分偏头痛患者中。
