Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 20:14:1301327.
doi: 10.3389/fonc.2024.1301327. eCollection 2024.

Connecting atrial fibrillation to digestive neoplasms: exploring mediation via ischemic stroke and heart failure in Mendelian randomization studies

Zhijie Xu #  1   2 , Xuezhi Rao #  1   3 , Yaxuan Xing  4 , Zhiwei Zhu  1   2 , Longmei Yan  1 , Jian Huang  5 , Jingchun Zhang  4 , Ruwen Zheng  5
Affiliations

Connecting atrial fibrillation to digestive neoplasms: exploring mediation via ischemic stroke and heart failure in Mendelian randomization studies

Zhijie Xu et al. Front Oncol. .

Abstract

Background: Notwithstanding the acknowledged interplay between atrial fibrillation (AF) and the emergence of digestive system neoplasms, the intricacies of this relationship remain ambiguous. By capitalizing univariable Mendelian Randomization (MR) complemented by a mediated MR tactic, our pursuit was to elucidate the causative roles of AF in precipitating digestive system malignancies and potential intermediary pathways.

Method: This research endeavor seeks to scrutinize the causal clinical implications of whether genetic predispositions to AF correlate with an increased risk of digestive system malignancies, employing MR analytical techniques. Utilizing a dataset amalgamated from six studies related to AF, encompassing over 1,000,000 subjects, we performed univariable MR assessments, employing the random-effects inverse-variance weighted (IVW) methodology as our principal analytical paradigm. Subsequently, a mediated MR framework was employed to probe the potential mediating influence of AF on the nexus between hypertension (HT), heart failure (HF), ischemic stroke (IS), coronary artery disease (CAD), and digestive system neoplasms.

Result: The univariable MR evaluation unveiled a notable causal nexus between the genetic inclination toward AF and the genetic susceptibility to colon, esophageal, and small intestine malignancies. The mediated MR scrutiny ascertained that the genetic inclination for AF amplifies the risk profile for colon cancer via IS pathways and partially explains the susceptibility to esophageal and small intestine tumors through the HF pathway.

Conclusion: Our investigative endeavor has highlighted a definitive causative association between genetic inclination to AF and specific digestive system neoplasms, spotlighting IS and HF as instrumental mediators. Such revelations furnish pivotal perspectives on the complex genetic interconnections between cardiovascular anomalies and certain digestive tract tumors, emphasizing prospective therapeutic and diagnostic worthy of pursuit.

Keywords: Mendelian randomization; atrial fibrillation; coronary artery disease; digestive system cancers; heart failure; hypertension; ischemic stroke.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Observational and genetic associations/mediations investigated in the present study.
Figure 2
Figure 2
The flow chart of the inclusion and exclusion criterion of candidate SNPs for each exposure-outcome pair. GWAS, genome-wide association studies; LID, Linkage disequilibrium; IVW, inverse-variance weighted; PRESSO, Pleiotropy Residual Sum and Outlier; MR, Mendelian randomization.
Figure 3
Figure 3
Associations of genetically predicted atrial fibrillation with seven digestive system cancers. IVW, inverse-variance weighted; MR, Mendelian Randomization; Cl, confidence interval; OR, Odds ratio; SNP, single nucleotide polymorphism.
See this image and copyright information in PMC

References

    1. Zhao M, Song L, Zhao Q, Chen Y, Li B, Xie Z, et al. . Elevated levels of body mass index and waist circumference, but not high variability, are associated with an increased risk of atrial fibrillation. BMC Med (2022) 20(1):215. doi: 10.1186/s12916-022-02413-1 - DOI - PMC - PubMed
    1. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. . Heart disease and stroke statistics-2020 update: A report from the American heart association. Circulation (2020) 141(9):e139–596. doi: 10.1161/CIR.0000000000000757 - DOI - PubMed
    1. Schnabel RB, Yin X, Gona P, Larson MG, Beiser AS, McManus DD, et al. . 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet Lond Engl (2015) 386(9989):154–62. doi: 10.1016/S0140-6736(14)61774-8 - DOI - PMC - PubMed
    1. Kahwati LC, Asher GN, Kadro ZO, Keen S, Ali R, Coker-Schwimmer E, et al. . Screening for atrial fibrillation: updated evidence report and systematic review for the US preventive services task force. JAMA (2022) 327(4):368–83. doi: 10.1001/jama.2021.21811 - DOI - PubMed
    1. Conen D, Wong JA, Sandhu RK, Cook NR, Lee IM, Buring JE, et al. . Risk of Malignant cancer among women with new-onset atrial fibrillation. JAMA Cardiol (2016) 1(4):389–96. doi: 10.1001/jamacardio.2016.0280 - DOI - PMC - PubMed