Abstract
BACKGROUND: Cardiovascular disease is the leading cause of death worldwide, and its risk is closely linked to metabolic abnormalities. Through summary-data-based mendelian randomization and colocalization analysis, we investigate the causal relationships between plasma proteins, six cardiovascular diseases (atrial fibrillation, coronary artery disease, heart failure, venous thromboembolism, peripheral artery disease and stroke), and 19 metabolic traits (including anthropometric phenotypes, blood pressure, glycemic phenotypes, inflammatory phenotypes, kidney-related phenotypes, lipidemic phenotypes, and liver-related phenotypes). RESULTS: We identify 49 proteins genetically associated with cardiovascular diseases, validated across two proteomic platforms. Among them, 35 are also associated with one or more metabolic phenotypes, with six showing evidence of colocalization. These six candidate proteins are classified into three categories based on drug development status, with PCSK9 already successful in therapies for cardiovascular diseases and hypercholesterolemia. DUSP13B, LRIG1, APOH, INHBC, and GUSB also demonstrate high therapeutic potential. Further phenome-wide MR analysis indicates that INHBC, APOH and DUSP13B represent promising therapeutic targets for cardiovascular diseases characterized by metabolic disorders. CONCLUSIONS: Overall, this study revealed causal plasma proteins underlying the onset of cardiovascular diseases and metabolic abnormalities, advancing the understanding of disease mechanisms and facilitating drug discovery.