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Published on: June 2, 2014
Causality between migraine and cardiovascular disease: a bidirectional Mendelian randomization study
Xirui Duan1, Xiaolan Du1, Guangrong Zheng1
1Department of Radiology, Yan'an Hospital of Kunming City (Yan'an Hospital, Kunming Medical University, Yunnan Cardiovascular Hospital), Kunming, China.
Insights
Migraine may protect against coronary artery disease and ischemic stroke, while coronary atherosclerosis and myocardial infarction may protect against migraine. Further research is needed to understand these cardiovascular disease and migraine links.
Area of Science:
- Cardiovascular disease genetics
- Neurology
- Epidemiology
Background:
- Growing evidence suggests a link between migraine and cardiovascular disease.
- Genetic evidence for a causal relationship is limited.
- Investigating this causal association is crucial.
Purpose of the Study:
- To investigate the bidirectional causal relationship between migraine and cardiovascular disease using genetic data.
- To explore potential protective effects in either direction.
Main Methods:
- Bidirectional Mendelian randomization (MR) study.
- Utilized publicly available genome-wide association study (GWAS) summary datasets.
- Employed four MR techniques (IVW, MR-Egger, weighted median, weighted mode) and sensitivity analyses (Cochran's Q, IVW radial, LOO, MR-PRESSO).
Main Results:
- Genetically predicted migraine showed protective causal effects on coronary artery disease (OR, 0.881) and ischemic stroke (OR, 0.912).
- Coronary atherosclerosis (OR, 0.865) and myocardial infarction (OR, 0.798) demonstrated protective causal effects on migraine.
Conclusions:
- Migraine may have a protective effect on coronary artery disease and ischemic stroke.
- Coronary atherosclerosis and myocardial infarction may protect against migraine.
- Highlights the need for further research on epidemiological and genetic differences, and long-term safety monitoring for migraine medications to improve cardiovascular outcomes.
Background:
While growing evidence suggests a relationship between migraine and cardiovascular disease, the genetic evidence for a causal relationship between migraine and cardiovascular disease is still scarce. Investigating the causal association between migraine and cardiovascular disease is vital.
Methods:
We carried out a bidirectional Mendelian randomization (MR) study including discovery samples and replication samples using publicly available genome-wide association study (GWAS) summary datasets and stringent screening instrumental variables. Four different MR techniques-Inverse variance weighted (IVW), MR ‒Egger, weighted median, and weighted mode-as well as various sensitivity analyses-Cochran's Q, IVW radial, leave-one-out (LOO), and MR-PRESSO-were utilized to investigate the causal relationship between cardiovascular disease and migraine.
Results:
The protective causal effects of genetically predicted migraine on coronary artery disease (OR, 0.881; 95% CI 0.790-0.982; p = 0.023) and ischemic stroke (OR, 0.912; 95% CI 0.854-0.974; p = 0.006) were detected in forward MR analysis but not in any other cardiovascular disease. Consistently, we also discovered protective causal effects of coronary atherosclerosis (OR, 0.865; 95% CI 0.797-0.940; p = 0.001) and myocardial infarction (OR, 0.798; 95% CI 0.668-0.952; p = 0.012) on migraine in reverse MR analysis.
Conclusion:
We found a potential protective effect of migraine on coronary artery disease and ischemic stroke and a potential protective effect of coronary atherosclerosis and myocardial infarction on migraine. We emphasised epidemiological and genetic differences and the need for long-term safety monitoring of migraine medications and future research to improve cardiovascular outcomes in migraine patients.
