USA: Results from a recent study provide reassurance about triptans being cardiovascular safe for use in people with migraine headaches. According to the study published in the Headache: The Journal of Head and Face Pain, no association was found between triptans exposure and an increased risk of cardiovascular events.
Some case reports have raise concerns on the association between management of migraine headaches with triptans and cardiovascular events. This study by Serena Ghanshani, University of Southern California, Los Angeles, CA, USA, and colleagues aimed to determine the strength of association between treatment with triptans and acute myocardial infarction, heart failure, and death. The researchers hypothesized that triptan exposure is not associated with increased cardiovascular events.
For the purpose, the researchers conducted a retrospective cohort study within an integrated healthcare delivery system in Southern California. 189,684 patients age ≥18 years had a diagnosis of migraine between January 2009 to December 2018. 130,656 were exposed to triptans. Patients treated with triptans were matched 1:1 to those not exposed to triptans by using a propensity score.
The primary outcome was acute myocardial infarction; secondary outcomes were heart failure, all‐cause death, and combined acute myocardial infarction, heart failure, and death.
Key findings of the study include:
The incidence rate of acute myocardial infarction was 0.67 per 1000 person‐year in triptan‐exposed vs 1.44 per 1000 person‐year in not exposed patients.
In propensity‐matched analyses, the adjusted hazard ratio for triptan exposure was 0.95 for acute myocardial infarction; 1.00 for all‐cause death; 0.93 for heart failure; and 0.99 for a composite of acute myocardial infarction, heart failure, or death.
Sensitivity analyses focusing on stratified subgroups based on age, gender, ethnicity, and several cardiac risk factors also revealed no significant association between triptan exposure and cardiovascular events.
"These data provide reassurance regarding the cardiovascular safety of utilizing triptans for the medical management of migraine headaches," concluded the authors.
The study, "Risk of Acute Myocardial Infarction, Heart Failure, and Death in Migraine Patients Treated with Triptans," was published in the Headache: The Journal of Head and Face Pain.
DOI: https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.13959