Stroke and the risk of gastrointestinal disorders: A Mendelian randomization study

Song, Jingru; Chen, Wenjing; Ye, Wei

doi:10.3389/fneur.2023.1131250

Cited by 6 publications

(3 citation statements)

References 76 publications

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“…Although this study provides a detailed assessment of the causal relationship between GERD and multiple CVDs, including any stroke, IS and ICH, and numerous CVD risk factors, it was not able to further analyze the causal relationship between GERD and various common subtypes of IS, and the causal association between stroke and its subtypes and GERD risk. Another previous MR study evaluated the causal relationship between stroke and gastrointestinal diseases, including GERD ( 23 ). This study found that ICH, especially deep ICH, can causally increase the risk of gastrointestinal disorders such as GERD.…”

Section: Discussionmentioning

confidence: 99%

Association between gastroesophageal reflux disease and stroke: a bidirectional Mendelian randomization study

Meng,

Zhang,

et al. 2024

Front. Neurol.

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ObjectiveSome previous studies have suggested a potential link between stroke and gastroesophageal reflux disease (GERD). We used a two-sample bidirectional Mendelian randomization (MR) method to explore the causal relationship between stroke and GERD.DesignSummary-level data derived from the published genome-wide association studies (GWAS) were employed for analyses. Single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) for stroke (n = 446,696) and its common subtypes ischemic stroke (IS) (n = 440,328), large vessel stroke (LVS) (n = 410,484), small vessel stroke (SVS) (n = 198,048), and cardioembolic stroke (CES) (n = 413,304) were obtained from the MEGASTROKE consortium. The data on intracerebral hemorrhage (ICH) (n = 721,135) come from the UK Biobank. Instrumental variables (IVs) for lacunar stroke (LS) (n = 474,348) and GERD (n = 602,604) were screened from publicly available genetic summary data. The inverse variance weighted (IVW) method was used as the main MR method. Pleiotropy was detected by the MR-Egger intercept test, MR pleiotropy residual sum and outlier, and leave-one-out analysis. Cochran Q statistics were used as supplements to detect pleiotropy.ResultsWe found that GERD can causally increase the risk of stroke [IVW odds ratio (OR): 1.22, 95% confidence interval (CI): 1.13–1.32, p = 1.16 × 10−6] and its common subtypes IS (OR: 1.19, 95% CI: 1.10–1.30, p = 3.22 × 10−5), LVS (OR: 1.49, 95% CI: 1.21–1.84, p = 1.47 × 10−4), and LS (OR: 1.20, 95% CI: 1.001–1.44, p = 0.048). Several important risk factors for stroke have also been implicated in the above causal relationship, including type 2 diabetes, sleep apnea syndrome, high body mass index, high waist-to-hip ratio, and elevated serum triglyceride levels. In reverse MR analysis, we found that overall stroke (OR: 1.09, 95% CI: 1.004–1.19, p = 0.039) and IS (OR: 1.10, 95% CI: 1.03–1.17, p = 0.007) have the causal potential to enhance GERD risk.ConclusionThis MR study provides evidence supporting a causal relationship between GERD and stroke and some of its common subtypes. We need to further explore the interconnected mechanisms between these two common diseases to better prevent and treat them.

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Section: Discussionmentioning

confidence: 99%

Association between gastroesophageal reflux disease and stroke: a bidirectional Mendelian randomization study

Meng,

Zhang,

et al. 2024

Front. Neurol.

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“…First, a genome-wide significance threshold of P < 5 × 10 − was used for SNP selection [14,15]. Secondly, in order to ensure the independence between the selected SNPs, they are required to have pairwise linkage disequilibrium (LD) r 2 < 0.001 and be at least kb =10000 away from each other [16,17]. Calculate R 2 to measure the proportion of variability.…”

Section: Study Design and Ivs Selectionmentioning

confidence: 99%

Association of coffee and caffeine consumption with risk of ischemic stroke: a Mendelian randomization study

Wang,

Gao,

Wang

et al. 2024

Preprint

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Background Previous research has not elucidated a causal relationship between coffee and caffeine intake and ischemic stroke. Methods Mendelian randomization (MR) studies were used to assess the causal relationship between coffee and caffeine consumption and the risk of ischemic stroke. Genetic statistically significant single nucleotide polymorphisms (SNPs) for coffee and caffeine intake served as instrumental variables (IVs). Ischemic stroke was used as the outcome, and the IVW, MR-Egger, simple mode, weighted mode, and weighted median methods were used for analysis, and the inverse variance weighting (IVW) method was used as the main method for MR analysis. Further sensitivity analysis was performed using MR-Egger and IVW to assess robustness. Results MR analysis results showed that coffee and caffeine intake were not associated with the risk of ischemic stroke. Twenty-three SNPs of coffee and 19 SNPs of caffeine were selected as IVs, and the F values of all SNPs were greater than 10. The study results show that genetic susceptibility to coffee intake is associated with IS (OR = 1.147, 95% CI: 0.704– 1.869, P = 0.583), and caffeine intake is associated with IS (OR = 0.93, 95% CI: 0.846– 1.021, P = 0.126) had no effect. After excluding SNPs with confounding factors, a sensitivity analysis was performed in this study, and the results were consistent. Conclusion The findings suggest there is insufficient evidence to support an association between coffee and caffeine intake and the risk of ischemic stroke. More research is needed to verify this in the future.

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“…RE independently increases the risk of stroke and TIA in hospitalized elderly patients with AF [ 35 ]. Moreover, GERD has been reported to be an independent causal risk factor for any stroke (odds ratio 1.19, 95% confidence interval 1.06–1.34) [ 36 ]. Similar findings were reported by another Mendelian randomization study [ 37 ].…”

Section: Do We Need New Scores For a Better Prediction Of Stroke And ...mentioning

confidence: 99%

Atrial High-Rate Episodes in Elderly Patients: The Anticoagulation Therapy Dilemma

Pimpini,

Biscetti,

Matacchione

et al. 2024

JCM

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Atrial fibrillation (AF) has been associated with higher morbidity and mortality rates, especially in older patients. Subclinical atrial fibrillation (SCAF) is defined as the presence of atrial high-rate episodes (AHREs) > 190 bpm for 10 consecutive beats > 6 min and <24 h, as detected by cardiac implanted electronic devices (CIEDs). The selection of eligible patients for anticoagulation therapy among elderly individuals with AHREs detected through CIEDs remains a contentious issue. The meta-analysis of ARTESiA and NOAH-AFNET 6 clinical trials revealed that taking Edoxaban or Apixaban as oral anticoagulation therapy can reduce the risk of stroke by approximately 32% while increasing the risk of major bleeding by approximately 62%. However, it is still unclear which are, among patients with SCAF, those who can take the highest net clinical benefit from anticoagulant therapy. The present review summarizes the current evidence on this intriguing issue and suggests strategies to try to better stratify the risk of stroke and systemic embolism in patients with AHREs. We propose incorporating some parameters including chronic kidney disease (CKD), obesity, enlarged left atrial volume, the efficacy in blood pressure management, and frailty into the traditional CHA2DS2-VASc score. Future trials will be needed to verify the clinical usefulness of the proposed prognostic score mainly in the view of a personalized therapeutic approach in patients with SCAF.

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Stroke and the risk of gastrointestinal disorders: A Mendelian randomization study

Cited by 6 publications

References 76 publications

Association between gastroesophageal reflux disease and stroke: a bidirectional Mendelian randomization study

Association between gastroesophageal reflux disease and stroke: a bidirectional Mendelian randomization study

Association of coffee and caffeine consumption with risk of ischemic stroke: a Mendelian randomization study

Atrial High-Rate Episodes in Elderly Patients: The Anticoagulation Therapy Dilemma

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