Writing in an accompanying editorial, Angela A. Indeed, Rist and colleagues reported “a small but statistically significant” improvement in the integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI) after adding MA status to both models, but did not observe significant improvements in categorical NRI.ĭespite the strong association with CVD risk, the team noted that the inclusion of MA information did not result in significant improvements in reclassification measures – adding that the relatively low prevalence of MA (5.1%) compared with other vascular risk factors likely inhibited its usefulness in improving risk stratification of existing CVD risk prediction models at the population level. “Those with MA were slightly younger, were more likely to have a family history of MI, had slightly higher median CRP values, and were less likely to have a history of diabetes than women without MA,” Rist and colleagues added.ĭuring an average of 10.2 years follow-up, the team observed 569 CVD events, of which 45 events (20 strokes, 17 MIs, and 8 CVD deaths) occurred among women with MA and 524 events (259 strokes, 197 MIs, and 68 CVD deaths) occurred among those who do not experience MA.Īnalysis found that MA status was significantly associated with CVD after including covariables in the Reynolds Risk Score (hazard ratio : 2.09 95% confidence interval : 1.54-2.84) and the AHA/ACC score (HR: 2.10 95% CI: 1.55-2.85).įurthermore, the team found that 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).
Initial analysis revealed that 5.1% of women eligible for analysis reported experiencing MA at baseline. We further excluded anyone missing information on any of the covariables included in the Reynolds Risk Score or the AHA/ACC score (n = 3,273), resulting in a final sample size of 24,493 women,” they said. “We excluded 1 woman who reported a history of myocardial infarction (MI) before baseline and 30 women missing information on MA status. Rist and colleagues noted that of the 39,876 participants in the WHS, 28,345 provided blood samples, while total cholesterol, high-density lipoprotein cholesterol (HDLC), high-sensitivity C-reactive protein (hsCRP), and hemoglobin A1c were able to be measured for 27,797 participants. “Adding information on MA status to commonly used CVD risk prediction algorithms enhanced model fit but did not substantially improve risk stratification,” they said.
“In this prospective cohort study of middle-aged women, MA status was associated with an increased likelihood of overall CVD events in the Reynolds and AHA/ACC risk prediction algorithms.” “Using 2 established CVD risk prediction algorithms, we examined whether including information on MA status would further improve their performance,” they said.
They noted that as part of enrollment for the WHS, participants self-reported MA status before then being followed for incidence CVD events. Rist, ScD, from Brigham and Women’s Hospital and Harvard Medical School, Boston. “Although the association between MA and CVD is independent from traditional vascular risk factors, the importance of MA on CVD occurrence relative to existing cardiovascular prediction tools remains unclear, as the majority of these tools have not considered including information on migraine status,” noted the research team behind the study, led by Pamela M. The study, published online Monday and in the June 13 issue of the Journal of the American College of Cardiology, analyzed data from the Women’s Health Study (WHS) to examine whether adding information on MA would improve the CVD risk prediction ability of two commonly used risk prediction algorithms, the Reynolds Risk Score and the American Heart Association (AHA)/American College of Cardiology (ACC) pooled cohort equation.
#Uncertain aura definition trial#
Despite the strong association of migraine with cardiovascular disease (CVD) risk, the relatively low prevalence of migraine with aura (MA) compared with other risk factors limits its usefulness in improving risk classification at the population level, according to a new analysis of existing trial data.
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