ABO blood group and risk of coronary artery disease. J Thromb Thrombolysis. 2013;36:286-287. [PMID: 23096597 DOI: 10.1007/s11239-012-0836-1]

ABO blood type is not a risk factor of outcome in aneurysmal subarachnoid hemorrhage patients

BACKGROUND

The association between ABO blood types and outcome of aneurysm subarachnoid hemorrhage (aSAH) has not reached a conclusion. This study was performed to testify the difference of outcome between ABO blood types.

METHODS

663 aSAH patients hospitalized in the West China hospital were enrolled. The association between ABO blood types and outcomes including mortality and delayed cerebral ischemia (DCI) was verified by the univariate and multivariate logistic regression. Glasgow Outcome Score (GOS) at discharge, length of ICU stay, length of hospital stay were also compared between different ABO blood types.

RESULTS

663 aSAH patients were divided into four groups according to their ABO blood types: AB type (46, 6.9%), A type (211, 31.8%), B type (169, 25.4%),O type (237, 35.7%). The GCS, WFNS, Hunt Hess, modified Fisher, aneurysm location and incidence of intraventricular hemorrhage did not show different distribution among ABO blood types. Among four coagulation indexes, only the activated partial thromboplastin time (APTT) showed different distribution among ABO blood types (p < 0.001). The AB group had the lowest level of APTT while O group had the highest level of APTT. Outcomes including delayed cerebral ischemia, mortality, GOS, length of ICU stay, and length of hospital stay did not show any significant differences among ABO types. Univariate logistic regression showed the ABO blood type was not associated with the development of DCI (p = 0.654) and the mortality (p = 0.430). The multivariate logistic regression showed ABO blood types were still not associated with DCI and mortality after adjusting confounding effects of significant risk factors.

CONCLUSIONS

The ABO blood type is not associated with the prognosis of aSAH patients. ABO blood types may not be helpful on risk stratification of aSAH.

Blood group and ischemic stroke, myocardial infarction, and peripheral vascular disease: A meta-analysis of over 145,000 cases and 2,000,000 controls

OBJECTIVE

Cardiovascular illnesses have been associated to ABO blood types, specifically through an effect on von Willebrand factor and factor FVIII levels. We conducted a meta-analysis to comprehensively explore the relationship between blood groups and ischemic stroke, myocardial infarction, and peripheral vascular disease.

MATERIALS AND METHODS

A comprehensive meta-analysis was undertaken to investigate blood groups and ischemic stroke (IS), myocardial infarction (MI) and peripheral vascular disease (PVD). Odds ratios (OR) were used to assess the relationship between blood groups and disease. RevMan v5,4 was used to statistically analyse the results. Risk of bias was assessed using the Newcastle-Ottawa scale.

RESULTS

A total of 72 studies (18 ischemic stroke, 37 myocardial infarction, 17 peripheral vascular disease) met our search criteria, totalling 145,499 cases and 2,113,736 controls. Mean age ranged between 18 and 90 years. Compared to blood group-O, non-O blood group had an increased association with IS (OR=1.13, 95%Cl: 1.07-1.21, P < 0.001), MI (OR=1.17, 95%Cl: 1.11-1.24, P < 0.001) and PVD (OR=1.15, 95%Cl: 1.04-1.28, P=0.005). Compared to blood group-O, blood group A had a stronger statistically significant association to IS (OR=1.19, P=0.001), MI (OR=1.22, P < 0.001) and PVD (OR=1.15, P=0.03). Blood group-B has the lowest risk associated with MI (OR=1.09, P=0.01). In addition, blood groups AB had a stronger statistically significant association to IS (OR=1.24, P=0.01), and MI (OR=1.20, P < 0.001) compared with the other blood groups.

CONCLUSIONS

Compared to blood group-O, groups A and AB are strongly associated to ischemic stroke, myocardial infarction, and peripheral vascular disease.

Blood Group and Incidence of Asthma and Chronic Obstructive Pulmonary Disease

Chronic respiratory diseases are determined by genetic predisposition, and environmental and socioeconomic variables. One genetic factor underlying susceptibility to such diseases can be the ABO blood group system. The purpose of this study was to investigate the hypothesis that there would be a relationship between the blood group and risk of developing asthma and chronic obstructive pulmonary disease (COPD). We reviewed medical history files of patients with the diagnosis of COPD or asthma, including those suffering from a cancerous disease accompanied by asthma or COPD, hospitalized from January 2016 to July 2017. The study involved 248 adult patients (85 women and 163 men; median age 65, range 20-95 years) with COPD (177; 71.4%) and asthma (71; 28.6%) with a known blood type. We found that the most frequent was blood type A (97; 39.1%) and the least blood type AB (26; 8.0%). The distribution of individual blood types in asthma was not different from that in COPD patients. Significant differences were found between the distribution of O and pooled non-O blood types (A, B, and AB); the pooled category was more frequent in both asthma and COPD patients. We conclude that the blood type is not a prognostic differentiating between the occurrence of asthma or COPD, although both are less common in people with blood type O. Further investigation is required to set the predisposing role of the ABO antigens for chronic respiratory diseases.

ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis

ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship between ABO blood group and coronary artery disease (CAD) is still controversial. We here performed an updated meta-analysis of the related studies and tried to elucidate the potential role of ABO blood group as a risk factor for CAD. All detectable case-control and cohort studies comparing the risk of CAD in different ABO blood groups were collected for this analysis through searching PubMed, Embase, and the Cochrane Library. Ultimately, 17 studies covering 225,810 participants were included. The combined results showed that the risk of CAD was significantly higher in blood group A (OR = 1.14, 95% CI = 1.03 to 1.26, p = 0.01) and lower in blood group O (OR = 0.85, 95% CI = 0.78 to 0.94, p = 0.0008). Even when studies merely about myocardial infarction (MI) were removed, the risk of CAD was still significantly higher in blood group A (OR = 1.05, 95% CI = 1.00 to 1.10, p = 0.03) and lower in blood group O (OR = 0.89, 95% CI = 0.85 to 0.93, p < 0.00001). This updated systematic review and meta-analysis indicated that both blood group A and non-O were the risk factors of CAD.

Meta-Analysis of Non-O Blood Group as an Independent Risk Factor for Coronary Artery Disease

To determine whether non-O blood group is an independent risk factor for coronary artery disease (CAD), we performed a meta-analysis of contemporary studies reporting adjusted relative risk estimates using multivariable logistic regression and multivariable Cox proportional hazards regression. MEDLINE and EMBASE were searched from January 2001 to March 2015 using Web-based search engines (PubMed and OVID). Search terms included blood group/type and coronary (artery/heart) disease, ischemic/ischaemic heart disease, acute coronary syndrome, myocardial infarction, or angina. Eligible were case-control, cross-sectional, or cohort studies reporting adjusted odds ratios (ORs) and hazard ratios (HRs) for CAD in subjects with non-O versus O blood group using multivariable logistic regression/multivariable Cox proportional hazards regression. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic ORs/HRs in the random-effects model. Of 117 potentially relevant articles screened initially, 12 relative risk estimates in 10 eligible studies were identified and included. Pooled analysis of all the 12 ORs/HRs demonstrated that non-O blood group was associated with a statistically significant 14% increase in CAD incidence relative to O blood group (OR/HR 1.14, 95% confidence interval 1.04 to 1.25, p = 0.006). There was no evidence of significant publication bias. Combining 8 studies reporting data regarding (acute) myocardial infarction also generated a statistically significant result unfavoring non-O blood group (OR/HR 1.16, 95% confidence interval 1.02 to 1.31, p = 0.02). In conclusion, we found that based on a meta-analysis of 10 studies enrolling a total of 174,945 participants, non-O blood group appears to be an independent risk factor for CAD and myocardial infarction.

Determination of ABO blood group genotypes using the real‑time loop‑mediated isothermal amplification method

ABO genotyping is commonly used in several situations, including blood transfusion, personal identification and disease detection. The present study developed a novel method for ABO genotyping, using loop‑mediated isothermal amplification (LAMP). This method allows the simultaneous determination of six ABO genotypes under 40 min at a constant temperature of 62˚C. The genotypes of 101 blood samples were determined to be AA (n=6), AO (n=38), BB (n=12), BO (n=29), AB (n=8) and OO (n=8) by the LAMP assay. The results were compared with the phenotypes determined by serological assay and the genotypes determined by direct sequencing, and no discrepancies were observed. This novel and rapid method, with good accuracy and reasonably cost effective, provides a supplement to routine serological ABO typing and may also be useful in other point‑of‑care testing.

Hemostasis, cancer, and ABO blood group: the most recent evidence of association

Human ABO blood group antigens are expressed on the surface of red blood cells and a variety of human cells and tissues. However, an increasingly number of studies show that the ABO blood group, in addition to its fundamental role in transfusion medicine and in several other disciplines, has a causal role in predisposing to several human diseases, including hemostasis and neoplastic disorders, which will be the focus of this narrative review.

Evolutionary aspects of ABO blood group in humans

The antigens of the ABO blood group system (A, B and H determinants) are complex carbohydrate molecules expressed on red blood cells and on a variety of other cell lines and tissues. Growing evidence is accumulating that ABO antigens, beyond their key role in transfusion medicine, may interplay with the pathogenesis of many human disorders, including infectious, cardiovascular and neoplastic diseases. In this narrative review, after succinct description of the current knowledge on the association between ABO blood groups and the most severe diseases, we aim to elucidate the particularly intriguing issue of the possible role of ABO system in successful aging. In particular, focus will be placed on studies evaluating the ABO phenotype in centenarians, the best human model of longevity.

Is ABO blood group truly a risk factor for thrombosis and adverse outcomes?

ABO blood type is one of the most readily available laboratory tests, and serves as a vital determinant in blood transfusion and organ transplantation. The ABO antigens are expressed not only on red blood cell membranes, determining the compatibility of transfusion, but also on the surface of other human cells, including epithelium, platelet and vascular endothelium, therefore extending the research into other involvements of cardiovascular disease and postoperative outcomes. ABO blood group has been recognized as a risk factor of venous thrombosis embolism since the 1960’s, effects now understood to be related to ABO dependent variations are procoagulant factor VIII (FVIII) and von Willebrand factor (vWF) levels. Levels of vWF, mostly genetically determined, are strongly associated with venous thromboembolism (VTE). It mediates platelet adhesion aggregation and stabilizes FVIII in plasma. Moreover, many studies have tried to identify the relationship between ABO blood types and ischemic heart disease. Unlike the clear and convincing associations between VTE and ABO blood type, the link between ABO blood type and ischemic heart disease is less consistent and may be confusing. Other than genetic factors, ischemic heart disease is strongly related to diet, race, lipid metabolism and economic status. In this review, we’ll summarize the data relating race and genetics, including ABO blood type, to VTE, ischemic heart disease and postoperative bleeding after cardiac surgery.

ABO blood group and thrombotic vascular disease

ABO blood group antigens are complex carbohydrate molecules expressed on red blood cells and a variety of tissues. The ABO blood type is implicated in the development of a number of human diseases and there is increasing evidence regarding its involvement in the pathogenesis of cardiovascular disorders, mainly through its effect on von Willebrand factor levels. In this review, after a brief analysis of the potential molecular mechanisms by which the blood group influences haemostasis, we focus on the clinical implications of such interaction. Overall, the literature data document the close relationship between venous thromboembolism (VTE) and non-O blood type, which is associated with an approximately two-fold increased risk of venous thrombosis. A supra-additive effect on VTE risk is observed when an inherited thrombophilic condition is associated with non-O blood group. A weaker association exists between non-O blood type and arterial thrombosis, which needs to be further investigated.

ABO blood group: old dogma, new perspectives

Human blood group antigens are glycoproteins and glycolipids expressed on the surface of red blood cells and a variety of human tissues, including the epithelium, sensory neurons, platelets and the vascular endothelium. Accumulating evidence indicate that ABO blood type is implicated in the development of a number of human diseases, including cardiovascular and neoplastic disorders. In this review, beside its physiologic role in immunohematology and transfusion medicine, we summarize the current knowledge on the association between the ABO blood group and the risk of developing thrombotic events and cancers.