Mendelian Randomization Study of Heart Failure and Stroke Subtypes

Frontiers in Cardiovascular Medicine

article

Quan Li¹  Shijiao Yan³  Yan Li¹  Hai Kang⁵  Huadong Zhu¹  Chuanzhu Lv² 

[1] Emergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College;Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China;School of Public Health, Hainan Medical University;Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences ,(No. 2019RU013), Hainan Medical University;Department of Emergency, Affiliated Yantai Yuhuangding Hospital of Qingdao University;Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University

关键词: heart failure;    intracerebral hemorrhage;    ischemic stroke;    Mendelian randomization;    stroke;   

DOI  :  10.3389/fcvm.2022.844733

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background Whether heart failure (HF) is an independent risk factor of ischemic stroke (IS) and hemorrhagic stroke remains controversial. We employed a multivariable Mendelian randomization (MR) to further investigate the causal effects of HF on the risk of stroke and stroke subtypes. Methods Genetically predicted HF was selected as an instrumental variable (IV) from published genome-wide association studies (GWAS) meta-analyses. Stroke data with different etiologies were extracted as outcome variables from another two GWAS meta-analyses. The random-effects inverse variance-weighted (IVW) model was applied as the main method, along with sensitivity analysis. Atrial fibrillation (AF), coronary heart disease (CHD), and systolic blood pressure (SBP) were controlled for mediating effects in multivariable MR. Results Genetically predicted HF was significantly associated with any IS [odds ratio (OR), 1.39; 95% CI, 1.12–1.74; p = 0.03], large artery stroke (LAS; OR, 1.84; 95% CI, 1.27–2.65; p = 0.001), and cardioembolic stroke (CES; OR, 1.73; 95% CI, 1.21–2.47; p = 0.003), but without small vessel stroke (SVS; OR, 1.1; 95% CI, 0.80–1.52; p = 0.56) and intracerebral hemorrhage (ICH; OR, 0.86; 95% CI, 0.41–1.83; p = 0.699) in univariable MR. However, these significant associations were attenuated to the null after adjusting for confounding factor in multivariable MR. Conclusion There was no direct causal association between HF and stroke in our study. The association between HF and IS can be driven by AF, CHD, and SBP.

【 授权许可】

CC BY