1. Introduction
death, Strokes, stroke, Acupuncture, ischemic stroke, headache disorders, Migraines, migraines, migraine, disability, strokes
REGRESSION, STROKES, STROKE, DISORDERS, ISCHEMIC STROKE, DISABLING DISEASE, HEADACHE DISORDERS, HEMORRHAGIC STROKES, MIGRAINES, MIGRAINES, MIGRAINE, MIGRAINE WITH AURA, STROKES
These authors contributed equally to this work.Migraines are common headache disorders and risk factors for subsequent strokes. Acupuncture has been widely used in the treatment of migraines; however, few studies have examined whether its use reduces the risk of strokes in migraineurs. This study explored the long-term effects of acupuncture treatment on stroke risk in migraineurs using national real-world data. We collected new migraine patients from the Taiwan National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2017. Using 1:1 propensity-score matching, we assigned patients to either an acupuncture or non-acupuncture cohort and followed up until the end of 2018. The incidence of stroke in the two cohorts was compared using the Cox proportional hazards regression analysis. Each cohort was composed of 1354 newly diagnosed migraineurs with similar baseline characteristics. Compared with the non-acupuncture cohort, the acupuncture cohort had a significantly reduced risk of stroke (adjusted hazard ratio, 0.4; 95% confidence interval, 0.35–0.46). The Kaplan–Meier model showed a significantly lower cumulative incidence of stroke in migraine patients who received acupuncture during the 19-year follow-up (log-rank test, Migraines are common neurovascular disorders affecting more than 1 billion people worldwide and are the second most disabling disease globally [Strokes, including ischemic and hemorrhagic strokes, are the leading causes of death and disability worldwide. According to one survey, the global lifetime risk of a stroke at age 25 and older is about 25% in both men and women [There is growing evidence that migraines increase the risk of strokes. A migraine with aura is considered a risk factor for ischemic stroke, while high frequency and recent onset of migraine are also associated with an increased risk of ischemic stroke [Acupuncture therapy is one of the main treatment techniques of traditional Chinese medicine. It has a history spanning more than 3000 years and is now widely used in countries all over the world. Acupuncture is considered to be an effective alternative therapy for migraines [To date, there has been no large-scale real-world evidence to show whether acupuncture is beneficial in reducing the risk of subsequent strokes in migraineurs. Therefore, we conducted a cohort study using a national database to explore the relationship between acupuncture intervention and stroke development in patients with migraines.