Wang Min, Chao Ce, Mei Kun, Di Dongmei, Qian Yongxiang, Wang Bin, Zhang Xiaoying
Department of Cardiothoracic Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Front Cardiovasc Med. 2023 Mar 17;10:1099861. doi: 10.3389/fcvm.2023.1099861. eCollection 2023.
In recent years, the incidence rates of rheumatoid arthritis (RA) and heart disease (HD) have noticeably increased worldwide. Previous studies have found that patients with RA are more likely to develop HD, while the cause and effect have still remained elusive. In this study, Mendelian randomization (MR) analysis was used to indicate whether there was a potential association between RA and HD.
Data of RA, ischemic heart disease (IHD), myocardial infarction (MI), atrial fibrillation (AF), and arrhythmia were based on the genome-wide association study (GWAS) dataset. No disease group was intersected. Inverse-variance weighted (IVW) method was used to calculate MR estimates, and sensitivity analysis was performed.
The primary MR analysis showed that genetic susceptibility to RA was significantly associated with the risk of IHD and MI, rather than with AF and arrhythmia. Besides, there was no heterogeneity and horizontal pleiotropy between the primary and replicated analyses. There was a significant correlation between RA and the risk of IHD (odds ratio (OR), 1.0006; 95% confidence interval (CI), 1.000244-1.00104; = 0.001552), meanwhile, there was a significant correlation between RA and the risk of MI (OR, 1.0458; 95% CI, 1.07061-1.05379; = 0.001636). The results were similar to those of sensitivity analysis, and the sensitivity analysis also verified the conclusion. Furthermore, sensitivity and reverse MR analyses suggested that no heterogeneity, horizontal pleiotropy or reverse causality was found between RA and cardiovascular comorbidity.
RA was noted to be causally associated with IHD and MI, rather than with AF and arrhythmia. This MR study might provide a new genetic basis for the causal relationship between RA and the risk of CVD. The findings suggested that the control of RA activity might reduce the risk of cardiovascular disease.
近年来，类风湿关节炎（RA）和心脏病（HD）的发病率在全球范围内显著上升。先前的研究发现，RA患者更易患HD，但其因果关系仍不明确。在本研究中，采用孟德尔随机化（MR）分析来表明RA与HD之间是否存在潜在关联。
RA、缺血性心脏病（IHD）、心肌梗死（MI）、心房颤动（AF）和心律失常的数据基于全基因组关联研究（GWAS）数据集。无疾病组交叉。采用逆方差加权（IVW）方法计算MR估计值，并进行敏感性分析。
主要的MR分析表明RA的遗传易感性与IHD和MI的风险显著相关，而非与AF和心律失常相关。此外，主要分析与重复分析之间不存在异质性和水平多效性。RA与IHD风险之间存在显著相关性（优势比（OR），1.0006；95%置信区间（CI），1.000244 - 1.00104；P = 0.001552），同时，RA与MI风险之间存在显著相关性（OR，1.0458；95% CI，1.07061 - 1.05379；P = 0.001636）。结果与敏感性分析相似，敏感性分析也验证了该结论。此外，敏感性和反向MR分析表明，RA与心血管合并症之间未发现异质性、水平多效性或反向因果关系。
RA被认为与IHD和MI存在因果关系，而非与AF和心律失常相关。这项MR研究可能为RA与心血管疾病风险之间的因果关系提供新的遗传基础。研究结果表明，控制RA活动可能降低心血管疾病风险。
