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Published on: November 9, 2017
Relationship between Guillain-Barré syndrome and cardiovascular disease: a bidirectional Mendelian randomization
Tianyi Wang1, Na Li2, Yong Zeng1
1Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Insights
Guillain-Barré syndrome (GBS) significantly increases heart failure (HF) risk. This study found no causal link between GBS and atrial fibrillation (AF) or coronary artery disease (CAD), nor reverse causality from cardiovascular diseases (CVDs) to GBS.
Area of Science:
- Neuroimmunology
- Cardiovascular Medicine
- Genetic Epidemiology
Background:
- Observational studies suggest an association between Guillain-Barré syndrome (GBS) and cardiovascular diseases (CVDs), but confounding factors may influence these findings.
- Understanding the causal relationship is crucial for managing GBS patients and preventing potential cardiac complications.
Purpose of the Study:
- To investigate the potential causal relationships between GBS and major CVDs, including heart failure (HF), atrial fibrillation (AF), and coronary artery disease (CAD).
- To assess bidirectional causality, examining both the effect of GBS on CVDs and the effect of CVDs on GBS.
Main Methods:
- A two-sample bidirectional Mendelian randomization (MR) analysis was employed using genetic data from European-ancestry individuals in the UK Biobank.
- Instrumental variables (IVs) for GBS and CVDs were identified based on genetic variations.
- Sensitivity analyses, including heterogeneity and horizontal pleiotropy tests, were performed to validate the robustness of the findings.
Main Results:
- Mendelian randomization analysis revealed a significant causal effect of GBS on an increased risk of developing heart failure (HF) (IVW, P < 0.05).
- No significant causal relationships were detected between GBS and atrial fibrillation (AF) or coronary artery disease (CAD).
- No evidence of a causal effect of CVDs (HF, AF, CAD) on the incidence of GBS was found.
Conclusions:
- Guillain-Barré syndrome is causally associated with an increased risk of heart failure in European populations.
- Clinical management of GBS patients should consider the heightened risk of heart failure.
- Further research may explore the underlying mechanisms linking GBS to HF.
Abstract:
Guillain-Barré syndrome (GBS) and cardiovascular diseases (CVDs) have been observed to have a potential association, with GBS potentially leading to cardiovascular complications. However, these observational studies may be influenced by confounding factors. This study aimed to assess the causal relationship between GBS and CVDs, including heart failure (HF), atrial fibrillation (AF), and coronary artery disease (CAD), using a two-sample bidirectional Mendelian randomization (MR) analysis. We analyzed four datasets from the UK Biobank, selecting only datasets of European origin according to predetermined criteria to avoid population stratification bias. Datasets for GBS and CVDs were retrieved from the UK Biobank and analyzed using selected instrumental variables (IVs) related to genetic variations. Sensitivity tests, including heterogeneity and horizontal pleiotropy tests, were conducted to ensure the reliability of the selected IVs. The analysis results were then visualized to illustrate the causal relationships. The study identified genetic variants as IVs for both GBS and CVDs. MR analysis revealed a significant causal effect of GBS on the increased risk of HF [inverse-variance weighted (IVW), P < 0.05], but no significant causal relationship was found between GBS and AF or CAD. Similarly, no causal effect of CVDs on the occurrence of GBS was observed. Sensitivity analyses indicated no significant heterogeneity or horizontal pleiotropy, supporting the robustness of the results. These findings underscore the importance of considering cardiovascular complications, particularly HF, in the clinical management of patients with GBS in European populations.NEW & NOTEWORTHY This study utilizes bidirectional Mendelian randomization to analyze the causal relationships between Guillain-Barré syndrome (GBS) and cardiovascular diseases (CVDs). It uniquely demonstrates a significant causal link from GBS to an increased risk of heart failure (HF), without similar effects on atrial fibrillation (AF) or coronary artery disease (CAD). No reverse causality from CVDs to GBS was found, highlighting the need for targeted cardiovascular management in patients with GBS.
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