Abstract | BACKGROUND:
Migraines affect 10% of the U.S. population and the episodes are frequently associated with significant disability. Triptans, 5HT1 receptor agonists, can be highly effective in treating pain and reducing disability. However, reports of cardiac events associated with triptan ingestion have led to concerns about its use in the face of possible cardiac disease. OBJECTIVE: DESIGN: DATA: Model inputs were derived from the literature and subjected to sensitivity analyses across all possible values. TIME HORIZON: Markov cycle is 1 week. OUTCOMES: The primary outcomes of interest were quality-adjusted life expectancy, in years (QALYs) and the impact of various cardiovascular risk levels on the preferred strategy. RESULTS: For the base case results were TREAT 19.4 QALYs, TEST 19.2, NOTRIPTAN 19.1. When altering CAD probability: TREAT dominated from 0 to 87%, TEST 87% to 97%, and NOTRIPTAN above 97%. Results were robust during sensitivity analyses. CONCLUSIONS: This analysis suggests that even for individuals with a relatively high risk of CAD it is not beneficial to perform cardiac testing, nor to avoid triptans. The exact level of cardiac risk at which testing should be considered is probably at or above 87%.
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Authors | Lori A Orlando, David B Matchar |
Journal | Headache
(Headache)
2004 Jul-Aug
Vol. 44
Issue 7
Pg. 652-60
ISSN: 0017-8748 [Print] United States |
PMID | 15209686
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Serotonin Receptor Agonists
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Topics |
- Cardiovascular Diseases
(chemically induced)
- Humans
- Markov Chains
- Migraine Disorders
(drug therapy)
- Models, Theoretical
- Risk Factors
- Serotonin Receptor Agonists
(adverse effects, therapeutic use)
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