Migraine drugs OK in terms of stroke, heart attack

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There’s reassuring news for people who have migraines: the modern “triptan” drugs that are effective for many sufferers do not increase the risk of having a heart attack or stroke, a new study shows.

Triptans, and older ergot derivatives, work by constricting blood vessels, which in theory might reduce blood-flow to the brain or heart enough to cause a problem. As Dr. Priscilla Velentgas and colleagues put it in an article in the journal Headache, “It has been speculated that the use of triptans or ergot alkaloid drugs might increase risk of ischemic events through vasoconstriction.”

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To investigate this possibility, the team matched a 130,411 migraine sufferers with 130,411 non-migraine patients who were members of UnitedHealthcare between 1995 and 1999.

The rate of heart attacks in both groups was about 1.4 cases per 1000 persons per year.

Compared with non-migraine subjects, those with migraine were 67 percent more likely to have a stroke during the study period. Migraine sufferers also had higher rates of serious angina and “mini-strokes.”

However, the risk of having a heart attack or stroke did not increase with current or recent use of triptan drugs.

Current users of ergot products were more likely to have a stroke or serious heartbeat irregularity than other migraine patients, although the relationship was not significant from a statistical viewpoint, the researcher note.

Velentgas is with Ingenix Epidemiology in Auburndale, Massachusetts, and the other authors are at Pfizer Inc. The study was supported by a contract between Pfizer and Ingenix Epidemiology.

SOURCE: Headache, July/August 2004.

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