Schizophrenia and Types of Stroke: A Mendelian Randomization Study
Background Previous studies suggest an association between schizophrenia and stroke, but no studies have investigated stroke subtypes. We examined potential causal associations between schizophrenia and a range of atherosclerotic, embolic, and hemorrhagic stroke outcomes. Methods and Results Two‐sam...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032011 |
| _version_ | 1797269089726496768 |
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| author | Shinya Nakada Frederick K. Ho Carlos Celis‐Morales Jill P. Pell |
| author_facet | Shinya Nakada Frederick K. Ho Carlos Celis‐Morales Jill P. Pell |
| author_sort | Shinya Nakada |
| collection | DOAJ |
| description | Background Previous studies suggest an association between schizophrenia and stroke, but no studies have investigated stroke subtypes. We examined potential causal associations between schizophrenia and a range of atherosclerotic, embolic, and hemorrhagic stroke outcomes. Methods and Results Two‐sample Mendelian randomization analyses were conducted. The summary‐level data (restricted to European ancestry) were obtained for schizophrenia and stroke: ischemic stroke, large‐artery stroke, small‐vessel stroke, cardioembolic stroke, and intracerebral hemorrhage. The associations between schizophrenia and each outcome were analyzed by an inverse variance weighting method primarily and Mendelian randomization Egger, weighted median, and weighted mode subsequently. The presence of pleiotropy was also tested by Cochran Q statistic, I2 index, and Mendelian randomization Egger intercept with scatter and funnel plots. We found associations between schizophrenia and cardioembolic stroke (odds ratio [OR], 1.070 [95% CI, 1.023–1.119]) and intracerebral hemorrhage (OR, 1.089 [95% CI, 1.005–1.180]) using inverse variance weighting. Little evidence of associations with the other stroke subtypes was found. Different Mendelian randomization methods corroborated the association with cardioembolic stroke but not intracerebral hemorrhage. Conclusions We have provided evidence of a potentially causal association between schizophrenia and cardioembolic stroke. Our findings suggest that cardiac evaluation should be considered for those with schizophrenia. |
| first_indexed | 2024-04-25T01:42:50Z |
| format | Article |
| id | doaj.art-18cedbd9b8b6471ba7e7d7e16b8a48f8 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-25T01:42:50Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-18cedbd9b8b6471ba7e7d7e16b8a48f82024-03-08T02:22:47ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-03-0113510.1161/JAHA.123.032011Schizophrenia and Types of Stroke: A Mendelian Randomization StudyShinya Nakada0Frederick K. Ho1Carlos Celis‐Morales2Jill P. Pell3School of Health and Wellbeing University of Glasgow Glasgow United KingdomSchool of Health and Wellbeing University of Glasgow Glasgow United KingdomSchool of Health and Wellbeing University of Glasgow Glasgow United KingdomSchool of Health and Wellbeing University of Glasgow Glasgow United KingdomBackground Previous studies suggest an association between schizophrenia and stroke, but no studies have investigated stroke subtypes. We examined potential causal associations between schizophrenia and a range of atherosclerotic, embolic, and hemorrhagic stroke outcomes. Methods and Results Two‐sample Mendelian randomization analyses were conducted. The summary‐level data (restricted to European ancestry) were obtained for schizophrenia and stroke: ischemic stroke, large‐artery stroke, small‐vessel stroke, cardioembolic stroke, and intracerebral hemorrhage. The associations between schizophrenia and each outcome were analyzed by an inverse variance weighting method primarily and Mendelian randomization Egger, weighted median, and weighted mode subsequently. The presence of pleiotropy was also tested by Cochran Q statistic, I2 index, and Mendelian randomization Egger intercept with scatter and funnel plots. We found associations between schizophrenia and cardioembolic stroke (odds ratio [OR], 1.070 [95% CI, 1.023–1.119]) and intracerebral hemorrhage (OR, 1.089 [95% CI, 1.005–1.180]) using inverse variance weighting. Little evidence of associations with the other stroke subtypes was found. Different Mendelian randomization methods corroborated the association with cardioembolic stroke but not intracerebral hemorrhage. Conclusions We have provided evidence of a potentially causal association between schizophrenia and cardioembolic stroke. Our findings suggest that cardiac evaluation should be considered for those with schizophrenia.https://www.ahajournals.org/doi/10.1161/JAHA.123.032011hemorrhagicischemicMendelian randomizationschizophreniastroke |
| spellingShingle | Shinya Nakada Frederick K. Ho Carlos Celis‐Morales Jill P. Pell Schizophrenia and Types of Stroke: A Mendelian Randomization Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease hemorrhagic ischemic Mendelian randomization schizophrenia stroke |
| title | Schizophrenia and Types of Stroke: A Mendelian Randomization Study |
| title_full | Schizophrenia and Types of Stroke: A Mendelian Randomization Study |
| title_fullStr | Schizophrenia and Types of Stroke: A Mendelian Randomization Study |
| title_full_unstemmed | Schizophrenia and Types of Stroke: A Mendelian Randomization Study |
| title_short | Schizophrenia and Types of Stroke: A Mendelian Randomization Study |
| title_sort | schizophrenia and types of stroke a mendelian randomization study |
| topic | hemorrhagic ischemic Mendelian randomization schizophrenia stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032011 |
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