No evidence of a causal relationship between ankylosing spondylitis and cardiovascular disease: a two-sample Mendelian randomization study

Abstract

ObjectiveObservational studies have suggested an increased risk of cardiovascular disease in individuals with ankylosing spondylitis. However, these studies are prone to confounding factors and reverse causality. To address these limitations, we conducted a Mendelian randomization study to assess the causal relationship between AS and CVD.MethodsThe study population comprises 9,069 individuals with ankylosing spondylitis and 509,093 individuals with either of six common cardiovascular diseases and a related indicator. Causal analysis using summary effect estimates and inverse variance weighting were employed as the main methods.ResultsThe CAUSE analysis showed no evidence of a causal relationship between AS and CVD. The odds ratios for total CVD, heart failure, myocardial infarction, valvular heart disease, ischemic heart disease, and venous thromboembolism, Arterial stiffness index, were as follows: OR, 1.01; 95% confidence interval, 0.96–1.05; P = 0.91; OR, 1.03; 95% CI, 0.99–1.08; P = 0.50; OR, 0.94; 95% CI, 0.86–1.03; P = 0.53; OR, 0.99; 95% CI, 0.94–1.04; P = 0.99; OR, 0.98; 95% CI, 0.91–1.04; P = 0.94; OR, 0.98; 95% CI, 0.91–1.04; P = 0.99; β, −0.0019; 95% CI, 0.97–1.01; P = 0.99. The IVW and weighted median methods also yielded consistent results, and no heterogeneity or pleiotropy was found. Likewise, a reverse Mendelian randomization analysis did not uncover a heritable causal relationship between AS and CVD.ConclusionThis Mendelian randomization study does not support a causal relationship between AS and CVD. Further research is needed to confirm this association.

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“…However, the mechanism behind this association is still unclear. Research has shown elevated levels of pro-inflammatory cytokines such as IL-6 and CRP in AS (Zhong et al, 2023), suggesting that inflammation may play a role. Studies have shown that AS can lead to obliterative endarteritis in small vessels supplying the atrioventricular node and the aortic root, leading to a prolongation of the PQ interval and an increased risk of atrial fibrillation, first-degree atrioventricular block, and aortic valve insufficiency (Haroon et al, 2015).…”

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“…However, the mechanism behind this association is still unclear. Research has shown elevated levels of pro-inflammatory cytokines such as IL-6 and CRP in AS (Zhong et al, 2023), suggesting that inflammation may play a role. Studies have shown that AS can lead to obliterative endarteritis in small vessels supplying the atrioventricular node and the aortic root, leading to a prolongation of the PQ interval and an increased risk of atrial fibrillation, first-degree atrioventricular block, and aortic valve insufficiency (Haroon et al, 2015).…”

Image1.TIF

“…However, the mechanism behind this association is still unclear. Research has shown elevated levels of pro-inflammatory cytokines such as IL-6 and CRP in AS (Zhong et al, 2023), suggesting that inflammation may play a role. Studies have shown that AS can lead to obliterative endarteritis in small vessels supplying the atrioventricular node and the aortic root, leading to a prolongation of the PQ interval and an increased risk of atrial fibrillation, first-degree atrioventricular block, and aortic valve insufficiency (Haroon et al, 2015).…”