The major cause of ischemic stroke is atrial fibrillation (AF). Various mechanisms have been suggested to explain the relationship between migraine and ischemic stroke, such as their common cardio-cerebrovascular risk factors, genetic predisposition, and the tendency to promote platelet aggregation, blood coagulation, and vascular intimal dysfunction in migraineurs ( 3). When accompanied by aura, migraine has a profound effect on the quality of life due to the severity of symptoms furthermore, it can be closely associated with ischemic stroke, especially in women ( 2). Migraine is a primary headache disease that can present with several neurological and autonomic symptoms, which are commonly prevalent in young to middle-aged women ( 1). Mechanisms that may explain sex differences in migraine’s adverse effect on AF should be further investigated, and the generalizability of our findings in other ethnic groups should be evaluated. We suggest that active surveillance for incident AF, combined with a lifestyle modification, could be advantageous, especially for young women who suffer from severe migraine with aura. What are its Clinical Implications and What is Yet to be Explored in the Future? Severe migraine without aura raised the long-term risk of AF by 16–21% in both men and women. A mild degree of migraine did not have any significant effect on the risk of AF development, regardless of sex, or the presence of accompanying aura. In this large-scale population-based study, women with severe migraine with aura had the highest chance of developing AF in the future (48% increase over the control group), while migraine with aura had no effect on the development of AF in men. What this Study Adds to the Existing Database? ![]() There is little evidence on the long-term risk of AF according to the type or severity of migraine or regarding sex differences. Atrial fibrillation (AF) has been suggested as a possible explanation for the link between migraine and ischemic stroke. Migraine, when accompanied with aura, is closely linked to ischemic stroke, particularly in women. Surveillance for incident AF and prompt lifestyle modification may be beneficial, particularly for young women suffering from severe migraine with aura. No significant association according to aura was observed in men with severe migraines ( p for interaction 0.011).Ĭonclusion: Severe migraine with aura significantly increased the risk of incident AF in women, but not in men. Severe migraine without aura modestly but significantly increased the risk of AF in both men and women compared to controls, with increase in AF risk being most prominent in women who had severe migraine with aura. Risk of AF in a mild degree of migraine was similar to that in the control group, regardless of sex or the presence of aura. Results: A total of 4,020,488 subjects were enrolled from January 1, to Decemand followed-up through Decem4,986 subjects had migraine with aura (age 50.6 ± 14.0 years, men 29.3%) and 105,029 had migraine without aura (age 51.6 ± 14.3 years, men 30.9%). Sex-difference in the effect of migraine on AF was evaluated. Newly developed AF was identified during a 10-year follow-up. The diagnosis, type, and severity of migraine were determined using claims data. Methods: We analyzed the nationwide health screening recipients in 2009 without previous AF diagnosis from the Korean National Health Insurance Service data. Objective: To evaluate sex differences in the risk of atrial fibrillation (AF) according to the type and severity of migraine. 5Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.4Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest and Heart Hospital, Liverpool, United Kingdom.3Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea. ![]() 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.1Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.ICD-10-CM G43.109 is grouped within Diagnostic Related Group(s) (MS-DRG v41.Tae-Min Rhee 1 Eue-Keun Choi 1,2* Kyung-Do Han 3 Hyo-Jeong Ahn 1 So-Ryoung Lee 1 Seil Oh 1,2 Gregory Y. (international classification of headache disorders, 2nd ed. Aura is usually followed by features of the common migraine, such as photophobia phonophobia and nausea. Aura may include a combination of sensory disturbances, such as blurred vision hallucinations vertigo numbness and difficulty in concentrating and speaking. A subtype of migraine disorder, characterized by recurrent attacks of reversible neurological symptoms (aura) that precede or accompany the headache.Migraine with aura without mention of refractory migraine.
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