Triptan use in elderly over 65 years and the risk of hospitalization for serious vascular events.
Elderly
Myocardial infarction
Stroke
Triptan
Journal
The journal of headache and pain
ISSN: 1129-2377
Titre abrégé: J Headache Pain
Pays: England
ID NLM: 100940562
Informations de publication
Date de publication:
26 Apr 2024
26 Apr 2024
Historique:
received:
28
12
2023
accepted:
12
04
2024
medline:
27
4
2024
pubmed:
27
4
2024
entrez:
26
4
2024
Statut:
epublish
Résumé
Several studies have focused on the use of triptan and the risk of acute vascular events but the existence of such association is still debated and has never been quantified in patients over 65 years. To assess whether triptan use among older is associated with an increased risk of hospitalization for acute vascular events. A propensity score-matched cohort study was designed using the French national health insurance database linked to hospital stays. Patients aged ≥ 65 years, newly treated by triptans between 2011 and 2014, were included… The primary event was hospitalization for an acute ischemic vascular event within de 90 days following triptan initiation. Association with triptan exposure was investigated through cox regression model, considering exposure at inclusion, and with exposure as a time-varying variable A case-crossover (CCO) and a self-controlled case series (SCCS) analyses were also conducted to address potential residual confounding. The cohort included 24, 774 triptan users and 99 096 propensity matched controls (mean (SD) age: 71 years (5.9), 74% of women). Within 90 days after cohort entry, 163 events were observed in the triptan group, and 523 in the control group (0.66% vs. 0.53%, adjusted hazard ratio (aHR) The incidence of acute vascular events was low among triptan users. We found that triptan use among older may be associated with a low increased risk for acute vascular events, which may be more marked for cerebral events such as stroke, than for cardiac events.
Sections du résumé
BACKGROUND
BACKGROUND
Several studies have focused on the use of triptan and the risk of acute vascular events but the existence of such association is still debated and has never been quantified in patients over 65 years. To assess whether triptan use among older is associated with an increased risk of hospitalization for acute vascular events.
METHODS
METHODS
A propensity score-matched cohort study was designed using the French national health insurance database linked to hospital stays. Patients aged ≥ 65 years, newly treated by triptans between 2011 and 2014, were included… The primary event was hospitalization for an acute ischemic vascular event within de 90 days following triptan initiation. Association with triptan exposure was investigated through cox regression model, considering exposure at inclusion, and with exposure as a time-varying variable A case-crossover (CCO) and a self-controlled case series (SCCS) analyses were also conducted to address potential residual confounding.
RESULTS
RESULTS
The cohort included 24, 774 triptan users and 99 096 propensity matched controls (mean (SD) age: 71 years (5.9), 74% of women). Within 90 days after cohort entry, 163 events were observed in the triptan group, and 523 in the control group (0.66% vs. 0.53%, adjusted hazard ratio (aHR)
CONCLUSION
CONCLUSIONS
The incidence of acute vascular events was low among triptan users. We found that triptan use among older may be associated with a low increased risk for acute vascular events, which may be more marked for cerebral events such as stroke, than for cardiac events.
Identifiants
pubmed: 38671362
doi: 10.1186/s10194-024-01770-x
pii: 10.1186/s10194-024-01770-x
doi:
Substances chimiques
Tryptamines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
68Informations de copyright
© 2024. The Author(s).
Références
Loder E (2010) Triptan therapy in migraine. N Engl J Med 363(1):63–70
doi: 10.1056/NEJMct0910887
pubmed: 20592298
Ghanshani S, Chen C, Lin B, Duan L, Shen YA, Lee MS (2020) Risk of Acute Myocardial Infarction, Heart failure, and death in Migraine patients treated with triptans. Headache 60(10):2166–2175
doi: 10.1111/head.13959
pubmed: 33017476
Hugger SS, Do TP, Ashina H, Goicochea MT, Jenkins B, Sacco S, Lee MJ, Brennan KC, Amin FM, Steiner TJ, Ashina M (2023) Migraine in older adults. Lancet Neurol 22(10):934–945
doi: 10.1016/S1474-4422(23)00206-5
pubmed: 37717587
Dodick D, Lipton RB, Martin V, Papademetriou V, Rosamond W, MaassenVanDenBrink A, Loutfi H, Welch KM, Goadsby PJ, Hahn S, Hutchinson S, Matchar D, Silberstein S, Smith TR, Purdy RA, Saiers J (2004) Triptan Cardiovascular Safety Expert Panel. Consensus statement: cardiovascular safety profile of triptans (5-HT agonists) in the acute treatment of migraine. Headache 44(5):414–425
doi: 10.1111/j.1526-4610.2004.04078.x
pubmed: 15147249
Hall GC, Brown MM, Mo J, MacRae KD (2004) Triptans in migraine: the risks of stroke, cardiovascular disease, and death in practice. Neurology 62(4):563–568
doi: 10.1212/01.WNL.0000110312.36809.7F
pubmed: 14981171
Lugardon S, Roussel H, Sciortino V, Montastruc JL, Lapeyre-Mestre M (2007) Triptan use and risk of cardiovascular events: a nested-case-control study from the French health system database. Eur J Clin Pharmacol 63(8):801–807
doi: 10.1007/s00228-007-0332-2
pubmed: 17576547
Velentgas P, Cole JA, Mo J, Sikes CR, Walker AM (2004) Severe vascular events in migraine patients. Headache 44(7):642–651
doi: 10.1111/j.1526-4610.2004.04122.x
pubmed: 15209685
Wammes-van der Heijden EA, Rahimtoola H, Leufkens HGM, Tijssen CC, Egberts ACG (2006) Risk of ischemic complications related to the intensity of triptan and ergotamine use. Neurology 67(7):1128–1134
doi: 10.1212/01.wnl.0000240128.76399.fa
pubmed: 17030745
Zebenholzer K, Gall W, Gleiss A, Pavelic AR, Wöber C (2022) Triptans and vascular comorbidity in persons over fifty: findings from a nationwide insurance database - A cohort study. Headache 62(5):604–612
doi: 10.1111/head.14304
pubmed: 35593784
pmcid: 9321590
Dekker F, Wiendels NJ, de Valk V et al (2011) Triptan overuse in the Dutch general population: nationwide pharmaco-epidemiology database analysis in 6.7 million people. Cephalalgia 31(8):943–952. https://doi.org/10.1177/0333102411408626
doi: 10.1177/0333102411408626
pubmed: 21593190
Braunstein D, Donnet A, Pradel V et al (2015) Triptans use and overuse: a pharmacoepidemiology study from the French health insurance system database covering 4.1 million people. Cephalalgia 35(13):1172–1180. https://doi.org/10.1177/0333102415570497
doi: 10.1177/0333102415570497
pubmed: 25667299
Panconesi A, Pavone E, Vacca F, Vaiani M, Banfi R (2008) Triptans in the Italian population: a drug utilization study and a literature review. J Headache Pain 9(2):71–76. https://doi.org/10.1007/s10194-008-0020-3
doi: 10.1007/s10194-008-0020-3
pubmed: 18317865
pmcid: 3476185
Biagi C, Poluzzi E, Roberto G, Puccini A, Vaccheri A, D’Alessandro R, Motola D, Montanaro N (2011) Pattern of triptan use and cardiovascular coprescription: a pharmacoepidemiological study in Italy. Eur J Clin Pharmacol 67(12):1283–1289
doi: 10.1007/s00228-011-1076-6
pubmed: 21674159
Tuppin P, Rudant J, Constantinou P et al (2017) Value of a national administrative database to guide public decisions: from the système national d’information interrégimes de l’Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France. Rev Epidemiol Sante Publique 65(Suppl 4):S149–S167. https://doi.org/10.1016/j.respe.2017.05.004
doi: 10.1016/j.respe.2017.05.004
pubmed: 28756037
Moulis G, Lapeyre-Mestre M, Palmaro A, Pugnet G, Montastruc J-L, Sailler L (2015) French health insurance databases: what interest for medical research? Rev Med Interne 36(6):411–417. https://doi.org/10.1016/j.revmed.2014.11.009
doi: 10.1016/j.revmed.2014.11.009
pubmed: 25547954
Palmaro A, Moulis G, Despas F, Dupouy J, Lapeyre-Mestre M (2016) Overview of drug data within French health insurance databases and implications for pharmacoepidemiological studies. Fundam Clin Pharmacol 30(6):616–624. https://doi.org/10.1111/fcp.12214
doi: 10.1111/fcp.12214
pubmed: 27351637
Tuppin P, Samson S, Woimant F, Chabrier S (2014) Management and 2-year follow-up of children aged 29 days to 17 years hospitalized for a first stroke in France (2009–2010). Arch Pediatr 21(12):1305–1315. https://doi.org/10.1016/j.arcped.2014.08.023
doi: 10.1016/j.arcped.2014.08.023
pubmed: 25287139
Danchin N, Neumann A, Tuppin P et al (2011) Impact of free universal medical coverage on medical care and outcomes in low-income patients hospitalized for acute myocardial infarction: an analysis from the FrenchNational Health Insurance system. Circ Cardiovasc Qual Outcomes 4(6):619–625. https://doi.org/10.1161/CIRCOUTCOMES.111.961193
doi: 10.1161/CIRCOUTCOMES.111.961193
pubmed: 21972406
Bezin J, Girodet P-O, Rambelomanana S et al (2015) Choice of ICD-10 codes for the identification of acute coronary syndrome in the French hospitalization database. Fundam Clin Pharmacol 29(6):586–591. https://doi.org/10.1111/fcp.12143
Neumann A, Maura G, Weill A, Ricordeau P, Alla F, Allemand H (2014) Comparative effectiveness of rosuvastatin versus simvastatin in primary prevention among new users: a cohort study in the French national health insurance database. Pharmacoepidemiol Drug Saf 23(3):240–250. https://doi.org/10.1002/pds.3544
doi: 10.1002/pds.3544
pubmed: 24292987
Maclure M (1991) The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol 133(2):144–153. https://doi.org/10.1093/oxfordjournals.aje.a115853
doi: 10.1093/oxfordjournals.aje.a115853
pubmed: 1985444
Gault N, Castañeda-Sanabria J, De Rycke Y, Guillo S, Foulon S, Tubach F (2017) Self-controlled designs in pharmacoepidemiology involving electronic healthcare databases: a systematic review. BMC Med Res Methodol 17(1):25
doi: 10.1186/s12874-016-0278-0
pubmed: 28178924
pmcid: 5299667
Farrington P, Pugh S, Colville A, Flower A, Nash J, Morgan-Capner P, Rush M, Miller E (1995) A new method for active surveillance of adverse events from diphtheria/tetanus/pertussis and measles/mumps/rubella vaccines. Lancet 345(8949):567–569
doi: 10.1016/S0140-6736(95)90471-9
pubmed: 7619183
Lafaurie M, Lapeyre-Mestre M, Sailler L, Sommet A, Moulis G (2022) Risk of Immune Thrombocytopenia after Influenza Vaccine. JAMA Intern Med 182(4):444–445
doi: 10.1001/jamainternmed.2021.8523
pubmed: 35188544
pmcid: 8861894
Bannay A, Chaignot C, Blotière P-O et al (2016) The best use of the Charlson Comorbidity Index with Electronic Health Care Database to Predict Mortality. Med Care 54(2):188–194. https://doi.org/10.1097/MLR.0000000000000471
doi: 10.1097/MLR.0000000000000471
pubmed: 26683778
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383. https://doi.org/10.1016/0021-9681(87)90171-8
doi: 10.1016/0021-9681(87)90171-8
pubmed: 3558716
Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA (2004) New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol 57(12):1288–1294. https://doi.org/10.1016/j.jclinepi.2004.03.012
Quan H, Sundararajan V, Halfon P et al (2005) Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 43(11):1130–1139. https://doi.org/10.1097/01.mlr.0000182534.19832.83
doi: 10.1097/01.mlr.0000182534.19832.83
pubmed: 16224307
WHO Collaborating Centre for Drug Statistics Methodology (2021) ATC Classification Index with DDDs, 2021. Oslo, Norway 2020. https://www.Whocc.No/Atc_ddd_index/
Prat M, Derumeaux H, Sailler L, Lapeyre-Mestre M, Moulis G (2018) Positive predictive values of peripheral arterial and venous thrombosis codes in French hospital database. Fundam Clin Pharmacol 32(1):108–113
doi: 10.1111/fcp.12326
pubmed: 29055145
Albieri V, Olsen TS, Andersen KK (2016) Risk of Stroke in migraineurs using triptans. Associations with Age, Sex, Stroke Severity and Subtype. EBioMedicine 6:199–205. https://doi.org/10.1016/j.ebiom.2016.02.039
doi: 10.1016/j.ebiom.2016.02.039
pubmed: 27211561
pmcid: 4856739
Lugardon S, Roussel H, Sciortino V, Montastruc JL, Lapeyre-Mestre M (2007) Triptan use and risk of cardiovascular events: a nested-case-control study from the French health system database. Eur J Clin Pharmacol 63(8):801–807. https://doi.org/10.1007/s00228-007-0332-2
doi: 10.1007/s00228-007-0332-2
pubmed: 17576547
Roberto G, Piccinni C, D’Alessandro R, Poluzzi E (2014) Triptans and serious adverse vascular events: data mining of the FDA adverse event reporting System database. Cephalalgia 34(1):5–13. https://doi.org/10.1177/0333102413499649
doi: 10.1177/0333102413499649
pubmed: 23921799
Petersen CL, Hougaard A, Gaist D, Hallas J (2024 Feb) Risk of stroke and myocardial infarction among initiators of triptans. JAMA Neurol 5:e235549
Donnet A, Emery C, Aly S et al (2019) Migraine burden and costs in France: a nationwide claims database analysis of triptan users. J Med Econ 22(7):616–624. https://doi.org/10.1080/13696998.2019.1590841
doi: 10.1080/13696998.2019.1590841
pubmed: 30836035
Riggins N, Ehrlich A (2022) Episodic migraine and older adults. Curr Pain Headache Rep 26(4):331–335
doi: 10.1007/s11916-022-01029-7
pubmed: 35384586
pmcid: 9007780
Kalkman DN, Couturier EGM, El Bouziani A, Dahdal J, Neefs J, Woudstra J, Vogel B, Trabattoni D, MaassenVanDenBrink A, Mehran R, de Winter RJ, Appelman Y (2023) Migraine and cardiovascular disease: what cardiologists should know. Eur Heart J 44(30):2815–2828
doi: 10.1093/eurheartj/ehad363
pubmed: 37345664
Ng CYH, Tan BYQ, Teo YN, Teo YH, Syn NLX, Leow AST, Ho JSY, Chan MY, Wong RCC, Chai P, Chan ACY, Sharma VK, Yeo LLL, Sia CH, Ong JJY (2022) Myocardial infarction, stroke and cardiovascular mortality among migraine patients: a systematic review and meta-analysis. J Neurol 269(5):2346–2358
doi: 10.1007/s00415-021-10930-x
pubmed: 34997286
Bigal ME, Golden W, Buse D, Chen Y-T, Lipton RB (2010) Triptan use as a function of cardiovascular risk. A population-based study. Headache 50(2):256–263. https://doi.org/10.1111/j.1526-4610.2009.01595.x
doi: 10.1111/j.1526-4610.2009.01595.x
pubmed: 20039953
Dodick D, Lipton RB, Martin V et al (2004) Consensus statement: cardiovascular safety profile of triptans (5-HT agonists) in the acute treatment of migraine. Headache 44(5):414–425. https://doi.org/10.1111/j.1526-4610.2004.04078.x
doi: 10.1111/j.1526-4610.2004.04078.x
pubmed: 15147249
MacClellan LR, Giles W, Cole J et al (2007) Probable migraine with visual aura and risk of ischemic stroke: the stroke prevention in young women study. Stroke 38(9):2438–2445. https://doi.org/10.1161/STROKEAHA.107.488395
doi: 10.1161/STROKEAHA.107.488395
pubmed: 17690308
Kurth T, Chabriat H, Bousser M-G (2012) Migraine and stroke: a complex association with clinical implications. Lancet Neurol 11(1):92–100. https://doi.org/10.1016/S1474-4422(11)70266-6
Gudmundsson LS, Scher AI, Aspelund T et al (2010) Migraine with aura and risk of cardiovascular and all cause mortality in men and women: prospective cohort study. BMJ 341:c3966. https://doi.org/10.1136/bmj.c3966
doi: 10.1136/bmj.c3966
pubmed: 20736269
pmcid: 2927696
de Hoon JN, Willigers JM, Troost J, Struijker-Boudier HA, Van Bortel LM (2000) Vascular effects of 5-HT1B/1D-receptor agonists in patients with migraine headaches. Clin Pharmacol Ther 68(4):418–426. https://doi.org/10.1067/mcp.2000.110502
doi: 10.1067/mcp.2000.110502
pubmed: 11061582
Van Den Maassen A, Saxena PR (2004) Coronary vasoconstrictor potential of triptans: a review of in vitro pharmacologic data. Headache 44(Suppl 1):S13–19. https://doi.org/10.1111/j.1526-4610.2004.04104.x
doi: 10.1111/j.1526-4610.2004.04104.x
Lorgis L, Gudjoncik A, Richard C et al (2012) Pre-infarction angina and outcomes in non-ST-segment elevation myocardial infarction: data from the RICO survey. PLoS ONE 7(12):e48513. https://doi.org/10.1371/journal.pone.0048513
doi: 10.1371/journal.pone.0048513
pubmed: 23272043
pmcid: 3525639
Li L, Setoguchi S, Cabral H, Jick S (2013) Opioid use for noncancer pain and risk of myocardial infarction amongst adults. J Intern Med 273(5):511–526. https://doi.org/10.1111/joim.12035
doi: 10.1111/joim.12035
pubmed: 23331508
Ray WA, Chung CP, Murray KT, Hall K, Stein CM (2016) Prescription of long-acting opioids and mortality in patients with chronic Noncancer Pain. JAMA 315(22):2415–2423. https://doi.org/10.1001/jama.2016.7789
doi: 10.1001/jama.2016.7789
pubmed: 27299617
pmcid: 5030814
Onan D, Wells-Gatnik WD, Bentivegna E, Lampl C, Martelletti P (2023) New Migraine drugs for older adults. Drugs Aging 40(4):301–305
doi: 10.1007/s40266-023-01012-w
pubmed: 36826751