Shared genetic associations and aetiology between obstructive sleep apnoea and cardiovascular diseases: a genome-wide cross-trait analysis and bidirectional Mendelian randomization analysis - Scorecard - MDSpire
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Shared genetic associations and aetiology between obstructive sleep apnoea and cardiovascular diseases: a genome-wide cross-trait analysis and bidirectional Mendelian randomization analysis
Clinical Scorecard: Genetic Links and Causal Relationships Between Obstructive Sleep Apnoea and Cardiovascular Disorders: Insights from a Genome-Wide Cross-Trait and Bidirectional Mendelian Randomization Study
At a Glance
Category
Detail
Condition
Obstructive Sleep Apnoea (OSA) and Cardiovascular Diseases (CVDs)
Key Mechanisms
Shared genetic loci and causal relationships identified via genome-wide association studies, Mendelian randomization, and latent causal variable analyses
Target Population
Adults of European ancestry with OSA and/or cardiovascular diseases including coronary artery disease, heart failure, myocardial infarction, stroke, and atrial fibrillation
Care Setting
Cardiovascular and sleep medicine clinical and research settings
Key Highlights
Strong genetic correlations exist between OSA and five major CVDs: coronary artery disease, heart failure, myocardial infarction, stroke, and atrial fibrillation.
Novel single-nucleotide polymorphisms and shared genetic loci between OSA and CVDs were identified through multi-trait GWAS analyses.
Bidirectional Mendelian randomization revealed atrial fibrillation as a causal factor for OSA and OSA as a causal factor for heart failure.
Guideline-Based Recommendations
Diagnosis
Consider genetic predisposition when evaluating patients with OSA and coexisting cardiovascular diseases.
Recognize the high prevalence of OSA in patients with hypertension, heart failure, coronary artery disease, and atrial fibrillation.
Management
Further research is needed to clarify the impact of OSA treatment on cardiovascular outcomes due to current inconclusive trial results.
Integrate genetic insights to improve recognition and targeted management of OSA in patients with cardiovascular disorders.
Monitoring & Follow-up
Monitor patients with atrial fibrillation for development or worsening of OSA symptoms given the causal relationship.
Assess heart failure patients for OSA as it may contribute causally to disease progression.
Risks
OSA is under-recognized and undertreated in cardiovascular disease populations despite strong genetic and causal links.
Confounding factors and shared risk profiles between OSA and CVDs complicate clinical interpretation without genetic analysis.
Patient & Prescribing Data
Middle-aged adults with diagnosed or suspected OSA and cardiovascular diseases of European ancestry
Current randomized controlled trials have not demonstrated that treating OSA reduces cardiovascular disease burden, highlighting the need for further research into genetic mechanisms and personalized treatment approaches.
Clinical Best Practices
Utilize genetic and genomic data to better understand patient risk profiles for OSA and cardiovascular diseases.
Apply Mendelian randomization and latent causal variable analyses to discern causal relationships in complex comorbid conditions.
Maintain vigilance for OSA in patients with atrial fibrillation and heart failure to optimize comprehensive cardiovascular care.
Despite major advances in guideline-directed medical therapy (GDMT), worsening heart failure continues to drive significant morbidity, repeat hospitalizations and healthcare utilization worldwide.
