Role of cigarette smoking in the development of ischemic stroke and its subtypes: a Mendelian randomization study

Clinical Epidemiology
Yu QianYingying Mao


Numerous studies have indicated that smokers have an increased risk of developing ischemic stroke. However, less is known about the causal relationship between cigarette smoking and ischemic stroke subtypes. In the present study, we aim to determine whether genetically predicted cigarette smoking was associated with subtypes of ischemic stroke using Mendelian randomization (MR). We used summary-level genetic association data from the MEGASTROKE consortium, including 438,847 individuals of European ancestry (34,217 cases of ischemic stroke and 404,630 controls). We used 176 single nucleotide polymorphisms as instrumental variables, which were previously identified to be associated with smoking in the Study of the Social Science Genetic Association Consortium (n=518,633). MR analyses were performed using inverse-variance-weighted method, weighted-median method, and MR-Egger regression. We found that genetically predicted smoking was associated with a higher risk of ischemic stroke (odds ratio (OR): 1.24, 95% CI: 1.10-1.39) and large artery ischemic stroke (OR: 1.52, 95% CI: 1.14-2.02), but not with risk of cardioembolic ischemic stroke or small vessel ischemic stroke. Sensitivity analyses using alternative MR approaches produced ...Continue Reading

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