Genetically Determined Rheumatoid Arthritis May Not Affect Heart Failure: Insights from Mendelian Randomization Study

Glob Heart. 2023 Aug 11;18(1):43. doi: 10.5334/gh.1256. eCollection 2023.

Abstract

Background: Evidence from observational epidemiological studies indicated that rheumatoid arthritis (RA) increased the risk of heart failure (HF). However, there is a possibility that the correlation is not explained as a causative role for RA in the pathogenesis of HF. A two-sample Mendelian randomization (MR) framework was designed to explore the potential etiological role of RA in HF to identify the target to improve the burden of HF disease.

Methods: To assess the causal association between RA and HF, we analyzed summary statistics from genome-wide association studies (GWASs) for individuals of European descent. Genetic instruments for RA were identified at a genome-wide significance threshold (p < 5 × 10-8). Corresponding data were obtained from a GWAS meta-analysis (95,524 cases and 1,270,968 controls) to identify genetic variants underlying HF. MR estimates were pooled using the inverse variance weighted method. Complementary analyses were conducted to assess the robustness of the results.

Results: There was no evidence of a causal association between genetically predicted RA and HF [odds ratio (OR), 1.00; 95% confidence interval (CI), 0.99-1.02; P = 0.60]. Various sensitivity analyses suggested no pleiotropy detected (all p > 0.05).

Conclusion: Our findings did not support the causal role of RA in the etiology of HF. As such, therapeutics targeted at the control of RA may have a lower likelihood of effectively controlling the occurrence of HF.

Keywords: Mendelian randomization; causal association; heart failure; rheumatoid arthritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Rheumatoid* / epidemiology
  • Arthritis, Rheumatoid* / genetics
  • Genome-Wide Association Study
  • Heart Diseases*
  • Heart Failure* / etiology
  • Heart Failure* / genetics
  • Humans
  • Mendelian Randomization Analysis
  • Polymorphism, Single Nucleotide

Grants and funding

This work was supported by the National Natural Science Foundation of China (Grant No. 82070416 and 82104632), the Shanghai Key Clinical Specialty Project (shslczdzk06202), the Top-level Clinical Discipline Project of Shanghai Pudong District Grant/Award Number: PWYgf 2021–01, and Health System Leading Talent Training program of Shanghai Pudong District Grant/Award Number: PWRq2021–24.