Migraine status helps improve CVD risk prediction

The addition of information on migraine with aura (MA) status to the cardiovascular disease (CVD) risk prediction algorithms results in a better model fit but falls short of substantially improving risk stratification among women, according to a study.

Participants who were enrolled in the Women’s Health Study self-reported their MA status and were followed for incident CVD events.

The authors included the MA status as a covariable in the Reynolds Risk Score and the American Heart Association (AHA)/American College of Cardiology (ACC) pooled cohort equation. They then assessed discrimination (Harrell c-index), continuous and categorical net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

MA status showed a significant association with CVD following the inclusion of covariables in the Reynolds Risk Score (hazard ratio [HR], 2.09, 95 percent confidence interval [CI], 1.54‒2.84) and the AHA/ACC score (HR, 2.10, 95 percent CI, 1.55‒2.85).

Adding information on MA status led to better 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).

A small but statistically significant improvement in the IDI and continuous NRI was observed following the addition of MA status to both models. However, no significant improvements were noted in the categorical NRI.

“Despite the strong association of migraine with CVD risk, the relatively low prevalence of MA compared with other CV risk factors limits its usefulness in improving risk classification at the population level,” the authors said.

“MA is associated with CVD independently from traditional vascular risk factors,” they noted.