| Title: | Asthma and incident coronary heart disease: an observational and Mendelian randomisation study |
| Journal: | European Respiratory Journal |
| Published: | 9 Nov 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/37945032/ |
| DOI: | https://doi.org/10.1183/13993003.01788-2023 |
| URL: | https://erj.ersjournals.com/content/erj/62/5/2301788.full.pdf |
Publication 8355
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Abstract
BACKGROUND: Observational studies suggest asthma is a risk factor for coronary heart disease (CHD) and sex modifies the risk, but they may suffer from methodological limitations. To overcome these, we applied a "triangulation approach", where different methodologies, with different potential biases, were leveraged to enhance confidence in findings.</p>
METHODS: First, we conducted an observational study using UK medical records to match asthma patients 1:1, by age, sex and general practitioner (GP) practice, to the general population. We measured the association between asthma and incident CHD (myocardial infarction: hospitalisation/death) by applying minimal sufficient adjustment: model 1, smoking, body mass index, oral corticosteroids, atopy and deprivation; model 2, additionally adjusting for healthcare behaviour (GP consultation frequency). Second, we conducted a Mendelian randomisation (MR) study using data from the UK Biobank, Trans-National Asthma Genetic Consortium (TAGC) and Coronary Artery Disease Genome-wide Replication and Meta-analysis consortium (CARDIoGRAM). Using 64 asthma single nucleotide polymorphisms, the effect of asthma on CHD was estimated with inverse variance-weighted meta-analysis and methods that adjust for pleiotropy.</p>
RESULTS: In our observational study (n=1 522 910), we found asthma was associated with 6% increased risk of CHD (model 1: HR 1.06, 95% CI 1.01-1.13); after accounting for healthcare behaviour, we found no association (model 2: HR 0.99, 95% CI 0.94-1.05). Asthma severity did not modify the association, but sex did (females: HR 1.11, 95% CI 1.01-1.21; males: HR 0.91, 95% CI 0.84-0.98). Our MR study (n=589 875) found no association between asthma and CHD (OR 1.01, 95% CI 0.98-1.04) and no modification by sex.</p>
CONCLUSIONS: Our findings suggest that asthma is not a risk factor for CHD. Previous studies may have suffered from detection bias or residual confounding.</p>
6 Authors
- Carlos A. Valencia-Hernández
- Fabiola Del Greco M
- Varun Sundaram
- Laura Portas
- Cosetta Minelli
- Chloe I. Bloom
1 Application
| Application ID | Title |
|---|---|
| 19136 | Lung Health: Genes and environment |
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