Genetic predisposition to anxiety and its association with myocardial infarction risk: A two-sample Mendelian randomization study

Psychological problems, including anxiety and depression, are becoming increasingly prevalent worldwide, and are strongly correlated with coronary artery disease, specifically myocardial infarction. Whereas genetic studies have linked depression to myocardial infarction, research exploring the genetic relationship between anxiety and myocardial infarction is lacking. The causal relationship between these conditions also remains uncertain. To determine whether a genetic predisposition to anxiety contributes causally to myocardial infarction. We used summary statistics from large-scale genome-wide association studies of anxiety and myocardial infarction to test the genetic correlation between the two datasets using Mendelian randomization analyses. Anxiety was found to increase the risk of myocardial infarction: Mendelian randomization-Egger odds ratio 28.638, 95% confidence interval 2.874–285.383 (=0.007); inverse variance weighted odds ratio 1.501, 95% confidence interval 1.046–2.153 (=0.027); weighted median odds ratio 1.757, 95% confidence interval 1.050–2.942 (=0.032). However, some directional pleiotropic effects of anxiety on myocardial infarction were observed. Analysis through R packages and Mendelian randomization-Egger methods supported a causal effect of anxiety on myocardial infarction. Mendelian randomization-robust adjusted profile score results also supported this conclusion. Our study provides evidence that a genetic predisposition to anxiety may play a causal role in the development of myocardial infarction. Early prevention and diagnosis of anxiety are crucial in managing myocardial infarction.