***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objectives To evaluate whether the association between migraine with aura and increased risk of cardiovascular disease is modified by vascular risk groups as measured by the Framingham risk score for coronary heart disease . Design Prospect i ve cohort study . Setting Women ’s health study , United States . Participants 27 519 women who were free from cardiovascular disease at baseline with available information on the Framingham risk score and migraine status . Main outcome measures Time to major cardiovascular disease event ( non-fatal myocardial infa rct ion , non-fatal ischaemic stroke , death from ischaemic cardiovascular disease ) , myocardial infa rct ion , and ischaemic stroke . Results At baseline , 3577 ( 13.0 % ) women reported active migraine , of whom 1418 ( 39.6 % ) reported migraine with aura . During 11.9 years of follow-up , there were 697 cardiovascular disease events . We stratified participants based on 10 year risk of coronary heart disease estimated from the Framingham risk score ( ≤1 % , 2 - 4 % , 5 - 9 % , and ≥10 % ) . Compared with women without migraine , the age adjusted hazard ratios in women with active migraine with aura were 1.93 ( 95 % confidence interval 1.45 to 2.56 ) for major cardiovascular disease , 1.80 ( 1.16 to 2.79 ) for ischaemic stroke , and 1.94 ( 1.27 to 2.95 ) for myocardial infa rct ion . When stratified by Framingham risk score , the association between migraine with aura and major cardiovascular disease was strongest in the lowest risk score group . There was a diametric association pattern for ischaemic stroke and myocardial infa rct ion . Compared with women without migraine , the age adjusted hazard ratios in women who reported migraine with aura in the lowest Framingham risk score group were 3.88 ( 1.87 to 8.08 ) for ischaemic stroke and 1.29 ( 0.40 to 4.21 ) for myocardial infa rct ion . Hazard ratios in women with migraine with aura in the highest Framingham risk score group were 1.00 ( 0.24 to 4.14 ) for ischaemic stroke and 3.34 ( 1.50 to 7.46 ) for myocardial infa rct ion . Women with migraine without aura were not at increased risk of ischaemic stroke or myocardial infa rct ion in any of the Framingham risk score groups . Conclusion The association between migraine with aura and cardiovascular disease varies by vascular risk status . Information on history of migraine and vascular risk status might help to identify women at increased risk for specific future cardiovascular disease events . Trial registration Clinical trials NCT00000479 Abstract Objective : To investigate the association between migraine and ischaemic or haemorrhagic stroke in young women . Design : Hospital based case-control study . Setting : Five European centres participating in the World Health Organisation Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception . Subjects : 291 women aged 20 - 44 years with ischaemic , haemorrhagic , or unclassified arterial stroke compared with 736 age and hospital matched controls . Intervention : Question naire . Main outcome measure : Self reported history of headaches . Results : Adjusted odds ratios associated with a personal history of migraine were 1.78 ( 95 % confidence intervals , 1.14 to 2.77 ) , 3.54 ( 1.30 to 9.61 ) , and 1.10 ( 0.63 to 1.94 ) for all stroke , ischaemic stroke , and haemorrhagic stroke respectively . Odds ratios for ischaemic stroke were similar for classical migraine ( with aura ) ( 3.81 , 1.26 to 11.5 ) and simple migraine ( without aura ) ( 2.97 , 0.66 to 13.5 ) . A family history of migraine , irrespective of personal history , was also associated with increased odds ratios , not only for ischaemic stroke but also haemorrhagic stroke . In migrainous women , coexistent use of oral contraceptives or a history of high blood pressure or smoking had greater than multiplicative effects on the odds ratios for ischaemic stroke associated with migraine alone . Change in the frequency or type of migraine on using oral contraceptives did not predict subsequent stroke . Between 20 % and 40 % of strokes in women with migraine seemed to develop directly from a migraine attack . Conclusions : Migraine in women of childbearing age significantly increases the risk of ischaemic but not haemorrhagic stroke . The coexistence of oral contraceptive use , high blood pressure , or smoking seems to exert a greater than multiplicative effect on the risk of ischaemic stroke associated with migraine Background The genes encoding proteins in the thrombomodulin-protein C pathway are promising c and i date genes for stroke susceptibility because of their importance in thrombosis regulation and inflammatory response . Several published studies have shown that the Ala455Val thrombomodulin polymorphism is associated with ischemic heart disease , but none has examined the association with stroke . Using data from the Stroke Prevention in Young Women Study , we sought to determine the association between the Ala455Val thrombomodulin polymorphism and the occurrence of ischemic stroke in young women . Methods All 59 hospitals in the greater Baltimore-Washington area participated in a population -based case-control study of stroke in young women . We compared 141 cases of first ischemic stroke ( 44 % black ) among women 15 to 44 years of age with 210 control subjects ( 35 % black ) who were identified by r and om digit dialing and frequency matched to the cases by age and geographical region of residence . Data on historical risk factors were collected by st and ardized interview . Genotyping of the thrombomodulin Ala455Val polymorphism was performed by pyrosequencing . Results The A allele ( frequency = 0.85 ) was associated with stroke under the recessive model . After adjustment for age , race , cigarette smoking , hypertension , and diabetes , the AA genotype , compared with the AV and VV genotypes combined , was significantly associated with stroke ( odds ratio 1.9 , 95 % CI 1.1–3.3 ) . The AA genotype was more common among black than white control subjects ( 81 % versus 68 % ) but there was no significant interaction between the risk genotype and race ( adjusted odds ratio 2.7 for blacks and 1.6 for whites ) . A secondary analysis removing all probable ( n = 16 ) and possible ( n = 15 ) cardioembolic strokes demonstrated an increased association ( odds ratio 2.2 , 95 % CI 1.2–4.2 ) . Conclusions Among women aged 15 to 44 years , the AA genotype is more prevalent among blacks than whites and is associated with increased risk of early onset ischemic stroke . Removing strokes potentially related to cardioembolic phenomena increased this association . Further studies are needed to determine whether this polymorphism is functionally related to thrombomodulin expression or whether the association is due to population stratification or linkage to a nearby functional polymorphism Background : Migraine and headache in general have been associated with subsequent risk of stroke , primarily in retrospective case-control studies . Prospect i ve data evaluating the association between specific headache forms and stroke are sparse . Methods : A prospect i ve cohort study was conducted among 39,754 US health professionals age 45 and older participating in the Women ’s Health Study with an average follow-up of 9 years . Incident stroke was self-reported and confirmed by medical record review . Results : A total of 385 strokes ( 309 ischemic , 72 hemorrhagic , and 4 undefined ) occurred . Compared with nonmigraineurs , participants who reported migraine overall or migraine without aura had no increased risk of any stroke type . Participants who reported migraine with aura had increased adjusted hazards ratios ( HRs ) of 1.53 ( 95 % CI 1.02 to 2.31 ) for total stroke and 1.71 ( 95 % CI 1.11 to 2.66 ) for ischemic stroke but no increased risk for hemorrhagic stroke .  Participants with migraine with aura who were < 55 years old had a greater increase in risk of total ( HR 1.75 ; 95 % CI 1.02 to 3.00 ) and ischemic ( HR 2.25 ; 95 % CI 1.30 to 3.91 ) stroke . Compared with participants without headache , headache in general and nonmigraine headache were not associated with total , ischemic , or hemorrhagic stroke . Conclusions : In these prospect i ve data , migraine was not associated with total , ischemic , or hemorrhagic stroke . In subgroup analyses , we found increased risks of total and ischemic stroke for migraineurs with aura . The absolute risk increase was , however , low , with 3.8 additional cases per year per 10,000 women Background and Purpose — Estimates of the incidence of ischemic stroke in young women vary widely from 0.9 to 8.9 per 100 000 per year . This study was conducted to determine the incidence and risk factors for ischemic stroke in young women in the UK . Methods — Women aged 15 to 49 with a first diagnosis and supporting evidence of ischemic stroke between January 1 , 1992 , and December 31 , 1998 , were identified from the UK General Practice Research Data base .  Age-specific incidence rates were calculated and a nested case-control study was conducted with up to 6 controls r and omly selected and matched to each case by year of birth and general practice . Crude and adjusted odds ratios ( ORs ) were calculated using conditional logistic regression . Results — The incidence of ischemic stroke was 3.56/100 000 per year . Factors associated with an increased risk were heart disease ( OR , 10.5 ) , heavy alcohol consumption ( OR , 8.5 ) , previous venous thromboembolism ( OR , 6.2 ) , treated diabetes mellitus ( OR , 4.7 ) , hypertension ( OR , 4.6 ) , migraine ( OR , 2.3 ) , and use of combined oral contraceptives ( OR , 2.3 ) . Light alcohol consumption was found to be protective ( OR , 0.17 ) . Conclusions — The crude incidence rate was lower than previously reported for the USA and Europe but higher than that reported for the UK Oxford Region . This could be because of an under-representation of mild cases or because of a true lower incidence in the UK compared with the USA and the rest of Europe . The results of the case-control study are consistent with previous studies of ischemic stroke in young women BACKGROUND A history of migraine has been proposed as a risk factor for  cerebral ischaemia in women under 45 . METHODS To investigate the association between history of migraine and cerebral ischaemia , we performed a case-control study of 308 patients aged 15 - 44 , with either transient ischaemic attack ( TIA ) or stroke , and of 591 age- and sex-matched controls prospect ively recruited in seven university hospitals . Crude and adjusted odds ratios were calculated using logistic regression analysis . FINDINGS A history of migraine was more frequent in patients than in controls ( 14.9 % vs 9.1 % ; adjusted odds ratio 1.9 , 95 % confidence interval 1.1 - 3.1 ) . In the prospect ively design ed subgroup analyses , a history of migraine reached the highest odds ratio ( 3.7 , 95 % CI 1.5 - 9 ) and was the only significant risk factor in women below age 35 ( p=0.003 ) ; atherogenic risk factors were more relevant in men and in patients older than 35 ; previous migraine attacks with aura were more frequent in stroke patients ( odds ratio 8.6 , 95 % CI 1 - 75 ) . INTERPRETATION Our findings indicated that the rare association between migraine and cerebral ischaemia is limited to women below age 35 , and suggest a need for careful clinical evaluation of comorbidity in the presence of migraine with aura OBJECTIVES This study seeks to determine whether menstrual-related migraine ( MRM ) has a discrete , attributable impact on migraine chronicity and medication overuse . BACKGROUND Menstrual-related migraine can be a disabling headache on its own ; but when seen in headache clinics , it is often enmeshed in the setting of chronic migraine ( CM ) and medication overuse headache ( MOH ) . Whereas nonspecific migraine preventives bestow their benefit uniformly , hormonal preventives (HPs)--when they are successful -- address a discrete hormonal mechanism . They confer no known benefit to migraines that are not hormonally triggered . This selective property of HPs could potentially isolate MRM and segregate its effect on the overall clinical picture . METHODS This is a retrospective review of 229 consecutive women seen in follow-up for hormonal prevention of MRM at an academic headache center . Patients kept st and ardized diaries from which separate menstrual-week ( MW ) and nonmenstrual week ( nonMW ) headache indices were calculated and compared . Resolution of MRM was defined by reduction of the MW headache index to a score not exceeding the nonMW headache indices . Consumption of all acute and preventive agents used in the preceding month was tallied . We 
    Output:
    
This systematic review shows a lack of good quality studies assessing risk of stroke associated with low dose estrogen use in women with migraine .
The available evidence is consistent with an additive increase in stroke risk with CHC use in women with migraine with aura .