心肌梗死、心力衰竭和心房颤动对脑血管意外的影响:一项孟德尔随机化研究  

Effect of Myocardial Infarction,Heart Failure and Atrial Fibrillation on Cerebrovascular Accidents:a Mendelian Randomized Study

作　　者：冉清智 李傲霜 陈恒文[1] 姚博 马静卓 张永康 RAN Qing-zhi;LI Ao-shuang;CHEN Heng-wen;YAO Bo;MA Jing-zhuo;ZHANG Yong-kang(Guang'anmen Hospital,China Academy of Traditional Chinese Medicine,Beijing,100053,China;Graduate School of Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700,China;Shanghai Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200082,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学东直门医院研究生院,北京100700 [3]上海中医药大学附属上海中西医结合医院,上海200082

出　　处：《现代生物医学进展》2024年第21期4064-4070,共7页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(82074396);中国中医科学院科技创新工程重大攻关项目(CI2021A05011);中国中医科学院科技创新工程创新团队项目(CI2021B017-05);高水平中医医院建设项目(CZ40909;CZ30977);新疆维吾尔自治区区域协同创新专项(上海合作组织科技伙伴计划及国际科技合作计划)项目民族药海外注册与临床国际科技合作与服务研究(2022E01001)。

摘　　要：目的:传统研究从观察和实证的角度表明,心血管疾病中的心肌梗死(MI)、心力衰竭(HF)、心房颤动(AF)和脑血管意外(CVA)之间存在密切联系,但上述心血管疾病与脑血管意外之间的因果关系尚未得到证实。因此,我们进行了一项孟德尔随机化(MR)研究,以探讨MI、HF、AF与CVA之间的因果关系。方法:采用逆方差加权法、加权中位数法和MR Egger法进行MR估计。在敏感性分析中使用了Cochran's Q检验、MR-Egger截距检验、MR-PRESSO、MR Steiger检验、leave-one-out分析和漏斗图。此外,还整理了MI、HF、AF的相关暴露SNPs。结果:MI、HF和AF分别与CVA进行孟德尔随机化,MR-Egger结果显示,MI与CVA风险相关(MI vs.CVA,P<0.05,OR(95%CI):420.722(3.45-51171.12));HF与CVA风险相关(HF vs.CVA,OR(95%CI):1.324(1.14-1.53));AF与CVA风险相关(AF vs.CVA,P<0.05,OR(95%CI):58671.12-149821.35)。结论:这项MR研究初步表明,MI、HF和AF与CVA的因果关系是可靠的。Objective:Traditional studies have shown a close association between myocardial infarction(MI),heart failure(HF),atrial fibrillation(AF)and cerebrovascular accidents(CVA)among cardiovascular diseases from both observational and empirical perspectives,but a causal relationship between the above cardiovascular diseases and CVA has not yet been confirmed.Therefore,we conducted a Mendelian randomization(MR)study to investigate the causal relationship between MI,HF,AF and CVA.Methods:MR estimation was performed using the inverse variance weighting method,weighted median method,and MR Egger method.Cochran's Q test,MR-Egger intercept test,MR-PRESSO,MR Steiger test,leave-one-out analysis,and funnel plot were used in sensitivity analysis.In addition,exposure SNPs associated with myocardial infarction,AF,and AF were collated.Results:MI,HF,and AF were Mendelian randomized to CVA separately,and MR-Egger results showed that MI was associated with the risk of CVA(MI vs.CVA,P<0.05,OR(95%CI):420.722(3.45 to 51171.12));HF was associated with the risk of CVA(HF vs.CVA,OR(95%CI):1.324(1.14 to 1.53));AF was associated with the risk of CVA(AF vs.CVA,P<0.05,OR(95%CI):58671.12).Conclusion:This MR study provides preliminary evidence that the causal association of MI,HF and AF with CVA is reliable.

关 键 词：心血管疾病 脑血管意外 孟德尔随机化(MR) 心肌梗死 心力衰竭 心房颤动 全基因组关联研究(GWAS) 

分 类 号：R181.2[医药卫生—流行病学]