Department of Geriatrics, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Department of Neurology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
J Stroke Cerebrovasc Dis. 2022 Mar;31(3):106267. doi: 10.1016/j.jstrokecerebrovasdis.2021.106267. Epub 2021 Dec 23.
Observational studies have shown that elevated circulating cardiac troponin I (cTnI) concentrations were linked to higher risk of stroke and atrial fibrillation, but the causality remains unclear. Therefore, we used mendelian randomization to assess the potential causal effects of cTnI concentrations on the risk of stroke, its subtypes and atrial fibrillation.
The instrumental variables for circulating cTnI concentrations were selected from a genome-wide association study meta-analysis of 48,115 European individuals. We examined the associations of circulating cTnI concentrations with stroke, ischemic stroke, ischemic stroke subtypes (cardioembolic, large artery, small vessel stroke), intracerebral hemorrhage and atrial fibrillation.
Genetically predicted elevated circulating cTnI concentrations were associated with higher risk of cardioembolic stroke (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.20-2.68; P = 0.004), but not associated with large artery stroke, small vessel stroke, total stroke, ischemic stroke and intracerebral hemorrhage. Additionally, we also found that elevated cTnI concentrations were causally linked to higher risk of atrial fibrillation (OR, 1.30; 95% CI, 1.10-1.53; P = 0.003).
This study provides evidence that genetically predicted circulating cTnI concentrations are causally linked to higher risk of cardioembolic stroke and atrial fibrillation.
观察性研究表明，循环心肌肌钙蛋白 I（cTnI）浓度升高与中风和心房颤动风险增加相关，但因果关系尚不清楚。因此，我们使用孟德尔随机化来评估 cTnI 浓度对中风、其亚型和心房颤动风险的潜在因果影响。
循环 cTnI 浓度的工具变量选自 48115 名欧洲个体的全基因组关联研究荟萃分析。我们研究了循环 cTnI 浓度与中风、缺血性中风、缺血性中风亚型（心源性栓塞、大动脉、小血管中风）、脑出血和心房颤动之间的关联。
遗传预测的循环 cTnI 浓度升高与心源性栓塞性中风的风险增加相关（优势比 [OR]，1.80；95%置信区间 [CI]，1.20-2.68；P=0.004），但与大动脉中风、小血管中风、总中风、缺血性中风和脑出血无关。此外，我们还发现 cTnI 浓度升高与心房颤动的风险增加有关（OR，1.30；95% CI，1.10-1.53；P=0.003）。
本研究提供了证据表明，遗传预测的循环 cTnI 浓度与心源性栓塞性中风和心房颤动的风险增加有关。
