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Stroke and Myocardial Infarction: A Bidirectional Mendelian Randomization Study.

Wenxian Sun1, Luyang Zhang1, Weishi Liu1

  • 1Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China.

International Journal of General Medicine
|December 17, 2021
PubMed
Summary

Large-artery stroke (LAS) causally increases myocardial infarction (MI) risk. While MI does not appear to cause stroke, understanding this link is crucial for cardiovascular health.

Keywords:
causal inferenceepidemiologic methodsgenome-wide association studylarge-artery strokesingle-nucleotide polymorphism

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Area of Science:

  • Cardiovascular epidemiology
  • Genetic epidemiology
  • Causal inference

Background:

  • Observational studies suggest a link between stroke and myocardial infarction (MI).
  • The causal nature of this association remains unclear.
  • Bidirectional causality requires rigorous investigation.

Purpose of the Study:

  • To investigate the bidirectional causal relationship between stroke and myocardial infarction (MI).
  • To differentiate between association and causation using genetic data.

Main Methods:

  • Two-sample Mendelian randomization (MR) was employed.
  • Genetic instruments for stroke and MI were derived from large genome-wide association studies.
  • Multiple MR methods and sensitivity analyses were used to ensure robustness.

Main Results:

  • Genetically predicted large-artery stroke (LAS) showed a causal effect on increasing MI risk (OR = 1.13).
  • MI phenotypes were genetically correlated with all ischemic strokes and LAS.
  • No significant causal effect of MI on stroke subtypes was observed after sensitivity analyses.

Conclusions:

  • Evidence supports a causal effect of large-artery stroke (LAS) on myocardial infarction (MI).
  • Potential mediating or confounding factors warrant further investigation.
  • Findings contribute to understanding the complex interplay between stroke and MI.