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La migraña y el riesgo de enfermedad cardiovascular en las mujeres
Tobias Kurth1, J Michael Gaziano, Nancy R Cook
1Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02215-1204, USA. tkurth@rics.bwh.harvard.edu
JAMA
|July 20, 2006
Resumen
La migraña con aura aumenta significativamente el riesgo de enfermedades cardiovasculares en las mujeres, incluidos el ataque cardíaco y el accidente cerebrovascular. La migraña sin aura no parece elevar estos riesgos.
Área de la Ciencia:
- Cardiología Cardiología.
- Neurología Neurología.
- Epidemiología La epidemiología.
Sus antecedentes:
- La migraña con aura está relacionada con factores de riesgo cardiovasculares pobres y estados protrombóticos.
- Si bien está asociado con el accidente cerebrovascular isquémico, su vínculo con la enfermedad cardiovascular (ECV) y los eventos coronarios más amplios no se entiende completamente.
Objetivo del estudio:
- Investigar la asociación entre la migraña, con y sin aura, y el riesgo subsiguiente de enfermedades cardiovasculares generales y específicas.
- Aclarar la relación entre los diferentes tipos de migraña y los resultados cardiovasculares en las mujeres.
Principales métodos:
- Un estudio de cohorte prospectivo que involucró a 27.840 mujeres estadounidenses de 45 años o más del Estudio de Salud de la Mujer.
- Los datos de seguimiento recopilados durante una media de 10 años, evaluando los principales eventos de ECV, accidente cerebrovascular isquémico, infarto de miocardio, revascularización coronaria y angina.
Principales resultados:
- Las mujeres con migraña activa con aura mostraron un riesgo significativamente mayor de ECV mayor (HR 2.15), accidente cerebrovascular isquémico (HR 1.91), infarto de miocardio (HR 2.08) y revascularización coronaria (HR 1.74).
- Se atribuyeron 18 eventos CVD mayores adicionales por cada 10.000 mujeres al año a la migraña con aura.
- No se observó un aumento en el riesgo de eventos vasculares en mujeres con migraña activa sin aura.
Conclusiones:
- La migraña activa con aura se asocia con un riesgo sustancialmente elevado de eventos cardiovasculares importantes, incluido el infarto de miocardio y el accidente cerebrovascular isquémico.
- Los hallazgos destacan la importancia de considerar el estado del aura en pacientes con migraña con respecto a la evaluación del riesgo cardiovascular.
- La migraña sin aura no demostró una asociación significativa con un mayor riesgo de ECV en esta cohorte.
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