Blood and urine biomarkers and myocardial infarction: A 2-sample and multivariate combination of Mendelian

Yu Ding1, Haoyang Ling2, Xiuyan Chen1

  • 1College of Acupuncture Moxibustion and Massage, Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, China.

Medicine
|December 10, 2025
PubMed

Insights

This study identified eight blood and urine biomarkers, including apolipoprotein B (APOB), linked to increased myocardial infarction (MI) risk. These findings offer new avenues for MI prevention and diagnosis.

Area of Science:

  • Cardiovascular Genetics
  • Biomarker Discovery
  • Metabolomics

Background:

  • Myocardial infarction (MI) is a leading cause of death globally, with current diagnostics often lacking preventative insights.
  • Early detection of cardiovascular diseases relies on blood and urine tests, but genetic predispositions require further investigation.
  • Mendelian randomization (MR) is a powerful tool for exploring genetic links between traits and diseases, aiding in identifying therapeutic targets.

Purpose of the Study:

  • To investigate the genetic associations between 35 blood and urine biomarkers and the risk of myocardial infarction (MI).
  • To identify specific biomarkers causally linked to MI development using genetic data.
  • To explore the underlying gene pathways and networks involved in MI pathogenesis through identified biomarkers.

Main Methods:

  • A bidirectional two-sample Mendelian randomization (MR) analysis was performed using UK Biobank and Finnish data (26,060 MI cases, 343,079 controls).
  • Four MR methods (inverse variance weighted, MR-Egger, weighted median, weighted mode) were employed, with inverse variance weighted used for final causal associations.
  • Sensitivity analyses, MR-PRESSO, PhenoScanner, and multivariate MR were utilized to ensure result validity and identify key genetic drivers.

Main Results:

  • A significant positive genetic association was found between eight blood and urine biomarker levels and elevated MI risk.
  • Key biomarkers identified include apolipoprotein B (APOB), glycated hemoglobin, HDL cholesterol, LDL cholesterol, sex hormone-binding globulin, triglycerides, and urate.
  • APOB, HDL cholesterol, and LDL cholesterol were found to selectively influence MI risk, with APOB playing a crucial role in collaboration with other genes.

Conclusions:

  • The study establishes a causal relationship between specific blood and urine biomarkers and MI risk.
  • Identified biomarkers, particularly APOB, provide novel insights into MI pathogenesis and potential therapeutic targets.
  • These findings support the use of blood and urine marker tests for early MI detection and understanding disease mechanisms.