Mendelian randomization study reveals a causal relationship between coronary artery disease and cognitive impairment
Shihan Xu1,2, Yanfei Liu1,2, Qing Wang1,2
1The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Insights
This study found that cognitive impairment may causally increase the risk of coronary artery disease (CAD). Screening for heart disease in individuals with cognitive decline could improve prevention strategies.
Area of Science:
- Cardiovascular Science
- Neuroscience
- Genetics
Background:
- Observational studies suggest a link between coronary artery disease (CAD) and cognitive impairment, but findings are inconsistent.
- A causal relationship between CAD and cognitive impairment requires further investigation.
Purpose of the Study:
- To investigate the potential causal relationship between coronary artery disease (CAD) and cognitive impairment using bidirectional two-sample Mendelian randomization (MR).
Main Methods:
- Utilized publicly available summary-level Genome-Wide Association Studies (GWAS) data.
- Employed five MR methods, including inverse-variance weighted (IVW), MR Egger, weighted median, weighted mode, and Wald ratio.
- Selected instrument variants based on stringent criteria to ensure robust analysis.
Main Results:
- Forward MR analysis showed limited evidence for a causal effect of CAD on cognitive impairment.
- Reverse MR analyses indicated a causal effect of fluid intelligence score, cognitive performance, and dementia with Lewy bodies on CAD.
Conclusions:
- The MR analysis provides evidence supporting a causal association between cognitive impairment and CAD.
- Findings suggest screening for coronary heart disease in patients with cognitive impairment may offer new insights into CAD prevention.
- The study offers potential clues for identifying risk factors and enabling early prediction of CAD.
Background:
Growing evidence suggests that Coronary artery disease (CAD) is associated with cognitive impairment. However, these results from observational studies was not entirely consistent, with some detecting no such association. And it is necessary to explore the causal relationship between CAD and cognitive impairment.
Objective:
We aimed to explore the potential causal relationship between CAD and cognitive impairment by using bidirectional two-sample mendelian randomization (MR) analyses.
Methods:
Instrument variants were extracted according to strict selection criteria. And we used publicly available summary-level GWAS data. Five different methods of MR [random-effect inverse-variance weighted (IVW), MR Egger, weighted median, weighted mode and Wald ratio] were used to explore the causal relationship between CAD and cognitive impairment.
Results:
There was little evidence to support a causal effect of CAD on cognitive impairment in the forward MR analysis. In the reverse MR analyses, We detect causal effects of fluid intelligence score (IVW: β = -0.12, 95% CI of -0.18 to -0.06, P = 6.8 × 10-5), cognitive performance (IVW: β = -0.18, 95% CI of -0.28 to -0.08, P = 5.8 × 10-4) and dementia with lewy bodies (IVW: OR = 1.07, 95% CI of 1.04-1.10, P = 1.1 × 10-5) on CAD.
Conclusion:
This MR analysis provides evidence of a causal association between cognitive impairment and CAD. Our findings highlight the importance of screening for coronary heart disease in patients of cognitive impairment, which might provide new insight into the prevention of CAD. Moreover, our study provides clues for risk factor identification and early prediction of CAD.
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