Association between triptan use and ischemic events in patients with ischemic risk factors: A meta-analysis

To investigate the relationship between ischemic events and triptan use in patients having ischemic risk factors and evaluate the safety profile of these medications in vulnerable individuals.

A detailed search was done using Web of Science, Google Scholar, PubMed, and Medline, up to December 2024. Inclusion criteria encompassed studies focusing on triptan use in individuals having predisposing ischemic risk factors and comparing the incidence of ischemic events between those who use triptans and those who do not. Studies were excluded if they targeted patients without ischemic risk factors, did not assess triptan use, or lacked a comparative analysis between users of triptans and non-users.

From an initial pool of 1,615 articles, f4 studies with a total sample size of 426,840 were involved in the study. The analysis revealed no significant statistical relationship between triptan use and ischemic events in patients with ischemic risk factors. Subgroup analysis of Ischemic Stroke (95% CI=0.70-8.78; p=0.16, I²=97.7%), Myocardial Infarction (95% CI = 0.44-2.39; p=0.95, I²= 96.1%) and All-cause Mortality events (95% CI=0.33-1.58; p=0.44, I²=98.8%).

Our findings indicate that the use of triptan is not linked to a higher risk of ischemic events, indicating that triptans can be a safe therapeutic option for managing migraines in patients with ischemic risk factors. Nevertheless, Additional research is required to assess the long-term safety of triptans, particularly in high-risk populations. Limitations include the inclusion of only four studies, a limited body of literature available for comparison, and discrepancies in follow-up durations across the included studies.PROSPERO Reg. No.: CRD42024580419.