Abstract P724: Perimenopausal Women With Migraine Present With Stroke at a Younger Age and With Less Comorbid Diabetes

Abstract

Introduction: Migraine is an independent risk factor for ischemic stroke. Frequency and severity increases in the perimenopausal period accompanied by marked vasomotor symptoms (VMS) such as hot flashes, flushing and night sweats. There is emerging evidence that VMS increases the risk of vascular disease including stroke. The purpose of this study was describe the demographics and co-morbidities of perimenopausal females with and without migraine that experience acute ischemic stroke (AIS). Methods: In this IRB approved study, electronic health record (EHR) data was obtained from a large, academic, comprehensive stroke center from 1/1/2015 to 1/1/2020. Inclusion criteria included female sex, age 42-65 years, and hospital diagnosis code of AIS. Hemorrhagic stroke, TIA, vasculopathy, and endocarditis associated strokes were excluded. Perimenopause was defined as age ≥42 and ≤65 years. Hormonal and menopausal status was not available in the EHR. We compared the baseline demographics and co-morbidities by ICD10 codes of subjects with and without migraine. Chi squared was used to compare categorical data and t test for continuous. Spearman rho was used to assess correlations. Results: We identified 660 subjects who met study criteria (n=83 with migraine; n=577 without migraine). Migraine positive subjects were significantly younger (mean age 58 vs 66 years, p=0.03) at time of AIS. Migraine positive subjects identified significantly more often as White (47%) compared to Black (10%), Asian (7%), Pacific Islander (1%), Native American/Alaskan (1%), Other/Mixed Race (31%), and unknown (3%), p=0.001. There was no significant difference in Hispanic ethnicity (p=0.87), hypertension (p=0.66), hyperlipidemia (p=0.12), or atrial fibrillation (p=0.84). Comorbid diabetes was significantly higher in the non-migraine group (94% vs 6%, p<0.001). Conclusion: Perimenopausal women with concomitant history of migraine present with AIS at younger ages and with lower rates of diabetes than those without a migraine history. Future research must be done to assess the correlation of menopausal symptom severity, hormone levels at time of AIS, and stroke characteristics to further understand the role of menopause in stroke risk.