Premium
Effect of genetic liability to migraine on coronary artery disease and atrial fibrillation: a Mendelian randomization study
Author(s) -
Daghlas I.,
Guo Y.,
Chasman D. I.
Publication year - 2020
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14111
Subject(s) - mendelian randomization , medicine , migraine , coronary artery disease , aura , cardiology , myocardial infarction , odds ratio , migraine with aura , atrial fibrillation , confidence interval , genetics , genetic variants , gene , genotype , biology
Background and purpose Observational studies have implicated migraine as a risk factor for coronary artery disease (CAD) and atrial fibrillation (AF); however, it is unclear whether migraine is causal in this relationship. Potential causality between genetically instrumented liability to migraine and cardiovascular disease outcomes was investigated using two‐sample Mendelian randomization. Methods The exposure comprised 35 independent, genome‐wide significant genetic variants identified in the largest published genome‐wide association study of migraine ( N cases = 59 674/ N controls = 316 078). The outcome datasets included genome‐wide association studies of CAD (76 014/264 785), myocardial infarction (43 676/128 199), angina (10 618/326 065) and AF (60 620/970 216). Mendelian randomization estimates were calculated using inverse‐variance weighted regression, and were further assessed with conventional Mendelian randomization sensitivity analyses. Results Evidence was found for a protective effect of migraine liability on CAD (odds ratio 0.86, 95% confidence interval 0.76–0.96, P = 0.003), myocardial infarction (0.86, 0.74–0.96, P = 0.01) and angina (0.86, 0.75–0.99, P = 0.04), but not on AF (1.00, 0.95–1.05, P = 0.88). Analyses by migraine subtype showed an effect of liability to migraine without aura on CAD risk (0.91, 0.84–0.99, P = 0.014), but not of migraine with aura (1.00, 0.97–1.03, P = 0.89). Sensitivity analyses indicated minimal bias by horizontal pleiotropy, outliers, reverse causality or sample overlap. Conclusions A potentially protective effect of genetically instrumented liability to migraine on CAD risk was identified. Mechanistic research investigating this link is warranted.