Impact of Migraine Headaches on Stress-Induced 'Takotsubo' Cardiomyopathy

Cardiovasc Revasc Med. 2022 Jul:40:78-81. doi: 10.1016/j.carrev.2022.03.005. Epub 2022 Mar 14.

Abstract

Introduction: Takotsubo cardiomyopathy (TCM) is an acute left ventricular dysfunction, typically due to a neuro-cardiogenic mechanism. Although many stressors can precipitate TCM, the role of migraines in hospitalized TCM patients has not been studied. Our objective is to describe the in-hospital outcomes of TCM in patients with a concurrent diagnosis of migraines.

Methods: We conducted a US-wide analysis of TCM hospitalizations from 2013 to 2017 by querying the National Inpatient Sample database for the International Classification of Diseases, Ninth and 10th Revisions (ICD-9 and ICD-10). Patients admitted with a principal diagnosis of TCM with a history of migraines were identified using the ICD-10 codes. TCM patients with migraines were then compared to TCM patients without migraines regarding mortality and acute inpatient complications (intubation, cardiac arrest, heart failure exacerbation, acute kidney injury). A logistic regression model was constructed to account for potential confounders.

Results: A total of 172,025 TCM patients were identified. Of those patients, 3610 suffered from migraines. TCM patients with a diagnosis of migraine were associated with a lower odds for mortality (OR: 0.388; [0.311-0.485]; p < 0.001) and acute complications (OR: 0.511 [0.471-0.554]; p < 0.001) compared to those without migraines. After adjusting for confounders, the adjusted odds ratio for mortality was 0.622; [0.495-0.782]; p < 0.001, and acute complications were 0.563 [0.519-0.611]; p < 0.001.

Conclusions: TCM patients with migraines were found to have a better outcome and mortality. They had significantly fewer complications (cardiac arrest, heart failure exacerbation, intubation, acute kidney injury).

Keywords: Migraine headaches; Mortality; Takotsubo cardiomyopathy.

MeSH terms

  • Acute Kidney Injury*
  • Cardiomyopathies*
  • Heart Arrest*
  • Heart Failure* / diagnosis
  • Heart Failure* / etiology
  • Heart Failure* / therapy
  • Humans
  • Migraine Disorders* / complications
  • Migraine Disorders* / etiology
  • Takotsubo Cardiomyopathy* / chemically induced
  • Takotsubo Cardiomyopathy* / complications
  • Takotsubo Cardiomyopathy* / therapy