Causal associations between ankylosing spondylitis and cardiovascular disease: a mendelian randomization analysis

Accumulating evidence suggests an association between Ankylosing Spondylitis (AS) and Cardiovascular Disease (CVD), yet the causal effects of AS on different CVD types remain unclear. This study aimed to determine the associations between AS and CVD using two-sample Mendelian Randomization (MR) analysis.

The genetically predicted causal relationships between AS and six common cardiovascular and cerebrovascular diseases (hypertension, atrial fibrillation, acute myocardial infarction, coronary atherosclerosis, angina, and heart failure) were evaluated using MR analysis. Data originated from Genome-Wide Association Studies (GWAS). Single Nucleotide Polymorphisms (SNPs; p < 5 × 10^-8, r² < 0.01) were selected as Instrumental Variables (IVs) for MR analysis. The primary outcome for causal inference was the Inverse Variance-Weighted (IVW) method, complemented by other methods (MR Egger, weighted median, simple mode, weighted mode). All results were presented as Odds Ratios (ORs). Heterogeneity and pleiotropy analyses were performed to ensure result stability and reliability.

MR results provided positive causal evidence for AS on hypertension (OR = 1.0143; 95% CI: 1.0038‒1.0248, p = 7.269 × 10^-3) and heart failure (OR = 1.0128; 95% CI: 1.0037‒1.0217, p = 5.76 × 10^-3). Conversely, none of the IVW methods indicated causal effects for AS on the other four diseases. Sensitivity analyses supported the robustness of the results.

This study indicates that ankylosing spondylitis has positive causal effects on hypertension and heart failure.