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(Stroke. 2009;40:2977.)
© 2009 American Heart Association, Inc.

Original Contributions

Migraine and Biomarkers of Endothelial Activation in Young Women

Gretchen E. Tietjen, MD; Nabeel A. Herial, MD, MPH; Leah White, MPH; Christine Utley, MSN, CNP; Janet M. Kosmyna, MIS, RN Sadik A. Khuder, PhD

From the Departments of Neurology (G.E.T., N.A.H., L.W., C.U., J.M.K.) and Medicine (S.A.K.), University of Toledo College of Medicine, Toledo, Ohio.

Correspondence to Gretchen E. Tietjen, MD, Department of Neurology, University of Toledo College of Medicine, Mail Stop No. 1195, 3120 Glendale Ave, RHC 1450, Toledo, OH 43614. E-mail gretchen.tietjen{at}utoledo.edu

Background and Purpose— There is mounting evidence of endothelial activation and dysfunction in migraine. Our objectives were to determine in a population of premenopausal women whether endothelial activation markers are associated with migraine.

Methods— Women (18 to 50 years) with and without migraine and free from cardiovascular disease were evaluated with tests of coagulation (von Willebrand factor activity, prothrombin fragment), fibrinolysis (tissue-type plasminogen activator antigen), inflammation (high-sensitivity C-reactive protein), and oxidative stress (homocysteine, total nitrate/nitrite concentrations, thiobarbituric acid–reactive substances).

Results— Sixty-one participants had migraine with aura (MA), 64 had migraine without aura (MO), and 50 were controls. Compared with controls, women with migraine had higher adjusted odds ratios for elevated von Willebrand factor activity of 6.51 (95% CI, 1.94 to 21.83) in those with MA and of 4.59 (95% CI, 1.37 to 15.38) in those with MO, elevated high-sensitivity C-reactive protein of 7.99 (95% CI, 2.32 to 27.61) in those with MA and of 2.63 (95% CI, 0.73 to 9.45) in those with MO, and for lower nitrate/nitrite levels of 6.60 (95% CI, 2.06 to 21.16) in those with MA and of 3.03 (95% CI, 0.90 to 10.15) in those with MO. Within the migraine group, von Willebrand factor activity was correlated with tissue-type plasminogen activator antigen (P=0.035) and nitrate/nitrite (P=0.024). There was a trend with high-sensitivity C-reactive protein (P=0.09).

Conclusions— In premenopausal women with migraine, particularly in those with MA, there is evidence of increased endothelial activation, a component of endothelial dysfunction.

Key Words: migraine • stroke • endothelial activation • endothelial dysfunction • von Willebrand factor • C-reactive protein

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