Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Wang Z et al. Safety of triptans in patients who have or are at high risk for cardiovascular disease: A target trial emulation. Mayo Clin Proc 2024 Nov; 99:1722. (https://doi.org/10.1016/j.mayocp.2024.03.023)

How unsafe are triptans

triptans — the mainstays of migraine therapy — are vasoactive, the U.S. FDA considers them to be contraindicated in patients with cardiovascular (CV) disease or elevated CV risk.

many patients with migraine (including those with CV disease) request triptans because they work

how bad are they??

Within 60 days of starting treatment, 52 patients who received triptans and 13 who received nontriptans experienced major adverse CV events — a significant difference (1.5% vs. 0.4%; relative risk, 4.0).

Compared with nontriptans, triptans are associated with elevated risk for major adverse CV events in patients with migraine and established CV disease or elevated CV risk; however, the absolute risk difference in this study was small (1.1%).


Jaksot(385)

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Let’s rewind to the early 2000s. Flip phones were cool, low-rise jeans were a crime, and the Women’s Health Initiative—WHI—dropped what became the medical equivalent of a headline: “Hormone Therapy In...

24 Maalis 12min

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

— rivaroxaban versus apixaban.Yes, folks, this is The Battle of the Blood Thinners!And spoiler alert — one of them came out looking like the overachiever in a safety class... while the other probably ...

20 Maalis 9min

Episode 421: 428. Asthma and Stroke --- A breathless combination

Episode 421: 428. Asthma and Stroke --- A breathless combination

Minocycline in Acute Ischemic Stroke (EMPHASIS trial)A multicenter, double-blind RCT in China studied 1,724 patients with acute ischemic stroke treated within 72 hours of onset. Patients received eith...

13 Maalis 16min

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Today, we're talking about Kawasaki disease-no, not the motorcycle company, though sometimes treating it does feel like trying to ride one at full speed through uncertainty.For decades, high-dose aspi...

11 Maalis 7min

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Setting the stagePicture this: your knee is like a three-room apartment. You've got a medial room, a lateral room, and a patellofemoral room. In isolated anteromedial osteoarthritis, just one room is ...

10 Maalis 11min

Episode 418: 425. Triptan initiation and cerebrovascular events

Episode 418: 425. Triptan initiation and cerebrovascular events

Kalapura C, et al. Triptan initiation and cerebrovascular events in patients with migraine: A nationwide cohort study. J Am Heart Assoc 2026 Feb 17; 15:e043409. DOI: 10.1161/JAHA.125.043409.  Today, w...

6 Maalis 6min

Episode 417: 424. GLP1 and NAION

Episode 417: 424. GLP1 and NAION

Li H-Y, et al. GLP-1 receptor agonists and risk of optic nerve or vision-threatening events in patients with type 2 diabetes or cardiometabolic diseases: A meta-analysis of randomized controlled trial...

5 Maalis 8min

Episode 416: 423. CME-- Discharge Questions Answered in 2025

Episode 416: 423. CME-- Discharge Questions Answered in 2025

CME-- Discharge Questions Answered in 2025

3 Maalis 45min

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