1
|
Rietveld IM, Lijfering WM, le Cessie S, Bos MHA, Rosendaal FR, Reitsma PH, Cannegieter SC. High levels of coagulation factors and venous thrombosis risk: strongest association for factor VIII and von Willebrand factor. J Thromb Haemost 2019; 17:99-109. [PMID: 30471183 DOI: 10.1111/jth.14343] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Indexed: 12/01/2022]
Abstract
Essentials Elevated procoagulant levels are associated with an increased risk of venous thrombosis (VT). The dependency on concurrent increased factor levels and VT was analyzed in a large study. Factor VIII (FVIII) and von Willebrand factor (VWF) were associated with the highest VT risk. The risks for other procoagulant factor levels were largely explained by FVIII and VWF. SUMMARY: Background Coagulation factors are essential for robust clot formation. However, elevated levels of procoagulant factors are associated with an increased risk of venous thrombosis (VT). The precise contribution of these factors to the development of VT is not yet understood. Objectives We determined the thrombosis risk for the highest levels of eight selected coagulation factors. Furthermore, we analyzed which of these coagulation factors had the strongest impact on the supposed association. Methods We used data of 2377 patients with a first VT and 2940 control subjects in whom fibrinogen, von Willebrand factor (VWF), factor II, FVII, FVIII, FIX, FX and FXI levels were measured. Results The odds ratios (ORs) for the various coagulation factor levels (> 99th percentile versus ≤ 25th percentile) varied between 1.8 and 4, except for FVIII (OR 23.0; 95% confidence interval [CI] 14.7-36.0) and VWF (OR 24.0; 95% CI 15.3-37.3). Adjustment for FVIII and VWF in a mediation analysis reduced the risks of the other factors to unity, with the exception of FIX and FXI (remaining ORs between 1.7 and 1.9). Conversely, the ORs for FVIII and VWF levels remained high after adjustment for all other procoagulant factors (FVIII: 16.0; 95% CI 9.7-26.3; VWF: 17.6; 95% CI 10.7-28.8). Conclusions Our results imply that the observed relationship between VT and coagulation factor levels can be largely explained by FVIII and VWF. FVIII and VWF levels were also associated with the highest VT risk.
Collapse
Affiliation(s)
- I M Rietveld
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - W M Lijfering
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - S le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands
| | - M H A Bos
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - F R Rosendaal
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - P H Reitsma
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - S C Cannegieter
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
2
|
Tufano A, Nardo A, Bonfanti C, Crestani S, Cerbone A, Franchini M, Coppola A. Non-O blood group as a risk factor for cerebral vein thrombosis. Thromb Haemost 2017; 110:197-9. [DOI: 10.1160/th13-02-0112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/21/2013] [Indexed: 11/05/2022]
|
3
|
Jang M, Yhim HY, Lee JO, Kim YK, Kim YK, Kim IH, Park S, Choi WI, Oh D, Kim DK, Kim HJ. ABO blood types are associated with risk of idiopathic venous thromboembolism in the Korean population. Thromb Haemost 2017; 107:799-801. [DOI: 10.1160/th11-11-0762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Accepted: 01/05/2012] [Indexed: 11/05/2022]
|
4
|
Navarro-Carpentieri D, Del Carmen Castillo-Hernandez M, Majluf-Cruz K, Espejo-Godinez G, Carmona-Olvera P, Moreno-Hernandez M, Lugo-García Y, Hernandez-Juarez J, Loarca-Piña L, Isordia-Salas I, Majluf-Cruz A. Impact of Classical Risk Factors for Arterial or Venous Thrombosis in Patients With Antiphospholipid Syndrome. Clin Appl Thromb Hemost 2017; 24:834-840. [PMID: 28884609 DOI: 10.1177/1076029617727859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
There are classical risk factors associated with arterial thrombosis (AT) or venous thromboembolic disease (VTD). However, less is known about these risk factors and AT or VTD episodes in patients with antiphospholipid syndrome (APS). Our aim was to elucidate whether APS-related thrombotic episodes are associated with the same risk factors as the non-APS population. We gathered demographics, medical history, complications, and causes of death associated with the risk factors for AT or VTD in patients with APS. We analyzed 677 thrombotic events in 386 patients. Type 2 diabetes mellitus and grade 3 obesity were associated with VTD instead of AT. There were no significant differences between the groups for almost all laboratory tests analyzed, although lupus anticoagulant was significantly higher in the VTD group. We suggest that thrombosis in APS is due to the APS itself and that the risks factors for AT or VTD do not have a main role. Our findings may have an ethnical background. Therefore, it may be difficult to elaborate predictive thrombotic clinical scores applicable to patients with different ethnical background.
Collapse
Affiliation(s)
- Daniel Navarro-Carpentieri
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Maria Del Carmen Castillo-Hernandez
- 2 Laboratorio de Farmacologia Cardiovascular, Seccion de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politecnico Nacional, Mexico City, Mexico
| | - Karim Majluf-Cruz
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Guillermo Espejo-Godinez
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Paola Carmona-Olvera
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Manuel Moreno-Hernandez
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Yolanda Lugo-García
- 4 Servicio de Hematologia, Hospital General Regional Carlos MacGregor Sanchez Navarro, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Jesús Hernandez-Juarez
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Irma Isordia-Salas
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Abraham Majluf-Cruz
- 1 Unidad de Investigacion Medica en Trombosis, Hemostasia y Aterogenesis, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| |
Collapse
|
5
|
Abstract
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.
Collapse
|
6
|
Franchini M, Mannucci PM. ABO blood group and thrombotic vascular disease. Thromb Haemost 2014; 112:1103-9. [PMID: 25187297 DOI: 10.1160/th14-05-0457] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/22/2014] [Indexed: 01/15/2023]
Abstract
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.
Collapse
Affiliation(s)
- M Franchini
- Massimo Franchini, MD, Director, Dipartimento di Medicina Trasfusionale ed Ematologia, Azienda Ospedaliera Carlo Poma, Mantova, Italy, Tel.: +39 0376 201234, Fax: +39 0376 220144, E-mail:
| | | |
Collapse
|
7
|
Fall AO, Proulle V, Sall A, Mbaye A, Ba PS, Diao M, Seck M, Gadji M, Gning SB, Diop S, Dièye TN, Faye BF, Thiam D, Dreyfus M. Risk factors for thrombosis in an african population. PLASMATOLOGY 2014; 7:1-6. [PMID: 25512718 PMCID: PMC4251055 DOI: 10.4137/cmbd.s13401] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 01/19/2014] [Accepted: 01/29/2014] [Indexed: 11/18/2022]
Abstract
SUMMARY Little is known about the biological, epidemiological, and clinical risk factors for thrombosis and venous thromboembolism (VTE) among Black Africans. We undertook a study of the prevalence of VTE risk factors for thrombosis in a Senegalese population. A three-year cross-sectional and case–control study involving 105 cases and 200 controls was conducted in various hospitals in Dakar (Senegal). Our results demonstrate that oral contraception, immobilization by casts, surgery, and blood group were significantly associated with VTE occurrence. Additionally, 16 cases and 2 controls had protein S (PS) values of less than 48.4% (M-2SD), exhibiting a highly significant difference (P < 1 × 10−4). The number of cases with a low protein C (PC) level was significantly higher than the respective number of controls. Using logistic regression methods, we established a correlation between significantly associated variables and deep venous thrombosis (DVT) occurrence. Age, obesity, sickle cell disease, and PC deficiency were not significantly associated with thrombosis. In contrast, gender, PS deficiency, varicose veins, surgery, non-O blood type, and the presence of antiphospholipid antibodies were significantly and independently associated with DVT. These findings are extremely useful for clinical management of patients suffering from DVT and can help to reduce the high recurrence rate observed in our study.
Collapse
Affiliation(s)
- Awa Ot Fall
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | | | - Abibatou Sall
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Alassane Mbaye
- Cardiology Department, "Grand Yoff" Hospital of Dakar, Senegal
| | - Pape Samba Ba
- Cardiology Department, Dakar Principal Hospital, Senegal
| | - Maboury Diao
- Cardiology Department, Aristide Le Dantec hospital of Dakar, Senegal
| | - Moussa Seck
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Macoura Gadji
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Sara B Gning
- Cardiology Department, Dakar Principal Hospital, Senegal
| | - Saliou Diop
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Tandakha Nd Dièye
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Blaise Félix Faye
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Doudou Thiam
- Laboratory of Hematology, Cheikh Anta Diop University of Dakar, Senegal
| | - Marie Dreyfus
- Laboratory of Hematology, Bicêtre Hospital of Paris, France
| |
Collapse
|
8
|
ABO blood group polymorphisms and risk for ischemic stroke and peripheral arterial disease. Mol Biol Rep 2014; 41:1771-7. [PMID: 24449362 DOI: 10.1007/s11033-014-3026-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/03/2014] [Indexed: 10/25/2022]
Abstract
Recent studies have demonstrated association between ABO blood system and thrombosis, indicating that individuals belonging to non-O blood groups (A, B or AB) present an increased risk of venous thrombosis, heart disease, and ischemic stroke (IS) as compared to O blood group carriers. In this study, we investigated the frequency of ABO blood group polymorphisms and its association with IS and peripheral arterial disease. Significant differences were observed for O1 (OR 0.57, 95% CI 0.35-0.95, p < 0.05) and O2 (OR 3.47, 95% CI 1.15-10.28, p < 0.05) alleles among IS patients while significant differences were observed for B phenotype (26.3 vs 9.5%, OR 3.42, 95% CI 1.32-8.76, p = 0.01, patients vs controls, respectively) and alleles A1 (OR 0.31, 95% CI 0.11-0.84, p < 0.05), O2 (OR 4.61, 95% CI 1.59-13.23, p < 0.01) and B (OR 3.42, 95% CI 1.62-7.13, p < 0.001) alleles for PAD patients. O1 allele was an independent variable (OR 0.27, 95% CI 0.12-0.57, p < 0.001) for IS patients. These data suggest the relationship of non-O blood groups in pathogenesis of thrombosis events and a possible protective effect of O blood group.
Collapse
|
9
|
Franchini M, Favaloro EJ, Targher G, Lippi G. ABO blood group, hypercoagulability, and cardiovascular and cancer risk. Crit Rev Clin Lab Sci 2012; 49:137-49. [PMID: 22856614 DOI: 10.3109/10408363.2012.708647] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The antigens of the ABO system (A, B, and H determinants, respectively) consist of complex carbohydrate molecules. It has been known for nearly half a century that the ABO blood group exerts a major influence on plasma levels of the von Willebrand factor (VWF)-factor VIII (FVIII) complex and that normal group O individuals have significantly lower levels of VWF and FVIII than do non-O individuals. As a consequence, several investigators have studied the association between ABO blood group and the risk of developing bleeding or thrombotic events. A number of epidemiological studies have also analyzed the biologic relevance of this interaction by assessing whether the ABO blood group could influence human longevity through the regulation of VWF-FVIII plasma levels. In this review, the molecular mechanisms by which the ABO blood group determines plasma VWF and consequently, FVIII levels, the possible clinical implications, and the current knowledge on the association between the ABO blood group and the risk of developing certain cancers will be reviewed.
Collapse
Affiliation(s)
- Massimo Franchini
- Dipartimento di Medicina Trasfusionale ed Ematologia, Azienda Ospedaliera Carlo Poma, Mantova, Italy.
| | | | | | | |
Collapse
|
10
|
Broadening the factor V Leiden paradox: pulmonary embolism and deep-vein thrombosis as 2 sides of the spectrum. Blood 2012; 120:933-46. [PMID: 22496157 DOI: 10.1182/blood-2012-02-407551] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Risk factors for deep-vein thrombosis have been shown not to be always the same as for pulmonary embolism. A well-known example is the factor V Leiden (FVL) paradox: the FVL mutation poses a clearly higher risk for deep-vein thrombosis (DVT) than for pulmonary embolism. We aimed to expand this paradox and therefore present risk estimates for several established risk factors for DVT and pulmonary embolism separately. When such separate risk estimates could not be retrieved from the literature, we calculated these risks in our own data, a large population-based case-control study on venous thrombosis (the MEGA study). Our results showed that the FVL paradox can be broadened (ie, the risk factors oral contraceptive use, pregnancy, puerperium, minor leg injuries, and obesity have an effect comparable with FVL). Furthermore, we found that pulmonary conditions, such as chronic obstructive pulmonary disease, pneumonia, and sickle cell disease, were risk factors with an opposite effect: a higher risk of pulmonary embolism, but little or no effect on DVT. These findings suggest that pulmonary embolism and DVT may not always have the same etiology, and encourage unraveling this phenomenon in further studies.
Collapse
|
11
|
Leonard DS, Fenton JE, Hone S. ABO blood type as a risk factor for secondary post-tonsillectomy haemorrhage. Int J Pediatr Otorhinolaryngol 2010; 74:729-32. [PMID: 20434223 DOI: 10.1016/j.ijporl.2010.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 02/25/2010] [Accepted: 03/01/2010] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Blood type-O is associated with decreased expression of von Willebrand factor. Type-O patients suffer fewer thrombotic problems and may be more prone to haemorrhage. Secondary post-tonsillectomy haemorrhage is the most common severe complication of tonsillectomy. We propose that type-O blood may be over-represented in patients presenting with secondary bleeds. METHODS We reviewed patients treated in the Royal Victoria Eye and Ear Hospital and the Midwestern Regional Hospital for secondary post-tonsillectomy haemorrhages from 2001 to 2006. RESULTS Three-hundred and three patients suffered secondary post-tonsillectomy haemorrhages over the study period. Blood group data was available in 206 cases (68%). Sixty-three percent of patients studied were blood group O, compared with 55% of the general population (p=0.01). CONCLUSIONS Blood group O is disproportionately represented in secondary post-tonsillectomy haemorrhage patients. Although we cannot demonstrate causality, this association suggests that patients with type-O blood are more likely to suffer from secondary bleeds following tonsillectomy.
Collapse
Affiliation(s)
- David S Leonard
- Department of Otolaryngology, Midwestern Regional Hospital, Dooradoyle, Limerick, Ireland.
| | | | | |
Collapse
|
12
|
Wiggins KL, Smith NL, Glazer NL, Rosendaal FR, Heckbert SR, Psaty BM, Rice KM, Lumley T. ABO genotype and risk of thrombotic events and hemorrhagic stroke. J Thromb Haemost 2009; 7:263-9. [PMID: 19036074 PMCID: PMC2946410 DOI: 10.1111/j.1538-7836.2008.03243.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The non-O alleles of the ABO genotype have been associated with an increased risk of thrombosis. Risk associated with the specific A(1), A(2) or B alleles is not well defined. OBJECTIVES To examine the association of the ABO genotype with myocardial infarction (MI), ischemic stroke, hemorrhagic stroke, and venous thrombosis (VT). PATIENTS AND METHODS We used data from two ongoing population-based case-control studies of MI, stroke, and VT. Cases included hypertensive adults and postmenopausal women with incident non-fatal MI (n = 1063), ischemic stroke (n = 469), and hemorrhagic stroke (n = 91), and postmenopausal women with incident non-fatal VT (n = 504). Controls were frequency matched to cases on age, sex, hypertension status, and year of identification. ABO genotypes were determined using single-nucleotide polymorphisms, and subjects were grouped by diplotype according to the presence of O(1), O(2), A(11), A(2) and B alleles. Logistic regression was used to test the association of diplotypes with risk of each outcome. RESULTS As compared with the O(1)O(1) group, the A(11) allele was associated with an increased risk of VT [odds ratio (OR) 1.79; 95% confidence interval (CI) 1.41-2.26] and MI (OR 1.23; 95% CI 1.05-1.44). The B allele was associated with an increased risk of VT (OR 1.82; 95% CI 1.29-2.57) and ischemic stroke (OR 1.59; 95% CI 1.17-2.17). The AB diplotype category was associated with a 2.7-fold risk of VT (OR 2.70; 95% CI 1.73-4.21). No other associations reached significance. CONCLUSIONS The VT and MI findings are confirmatory, and the ischemic stroke finding with the B allele is a novel finding and needs replication.
Collapse
Affiliation(s)
- K L Wiggins
- Department of Medicine, University of Washington, Seattle, WA 98101, USA.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Wu O, Bayoumi N, Vickers MA, Clark P. ABO(H) blood groups and vascular disease: a systematic review and meta-analysis. J Thromb Haemost 2008; 6:62-9. [PMID: 17973651 DOI: 10.1111/j.1538-7836.2007.02818.x] [Citation(s) in RCA: 272] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Associations between vascular disease and ABO(H) blood groups have a long history, but no consensus exists regarding its magnitude and significance, or whether it relates to all disorders equally. An accurate calculation of risk would allow direct assessment of whether the effects of non-O status on thrombosis risk are of the magnitude predicted by its effect on von Willebrand factor/FVIII levels. METHODS AND RESULTS We conducted a systematic review and meta-analysis of studies reporting associations with non-O blood groups. This gave pooled odds ratios of 1.25 [95% confidence interval (CI) 1.14-1.36] for myocardial infarction (MI), 1.03 (95% CI 0.89-1.19) for angina, 1.45 (95% CI 1.35-1.56) for peripheral vascular disease, 1.14 (95% CI 1.01-1.27) for cerebral ischemia of arterial origin, and 1.79 (95% CI 1.56 to 2.05) for venous thromboembolism (VTE). However, restriction to prospective MI studies only did not confirm the association (OR 1.01; 95% CI 0.84-1.23), although these studies may have failed to capture early-onset disease. For VTE, using a combined group of OO/A(2)A(2)/A(2)O as index, the combination of A(1)A(1)/A(1)B/BB gave an OR of 2.44 (95% CI 1.79-3.33) and A(1)O/ BO/A(2)B an OR of 2.11 (95% CI 1.66-2.68). CONCLUSIONS This study confirms the historical impression of linkage between some vascular disorders and non-O blood group status. Although the odds ratios are similar to those predicted by the effect of ABO(H) on von Willebrand factor levels, further work is required to assess risk prospectively and to refine the effect of reducing O(H) antigen expression on thrombosis. However, as non-O and particularly A(1)A(1), A(1)B, BB constitute a significant proportion of the population attributable fraction of VTE, there may be a role for more widespread adoption of ABO(H) typing in testing strategies.
Collapse
Affiliation(s)
- O Wu
- Section of Geriatric Medicine and Section of Public Health and Health Policy, University of Glasgow, Glasgow, UK
| | | | | | | |
Collapse
|
14
|
Ohira T, Cushman M, Tsai MY, Zhang Y, Heckbert SR, Zakai NA, Rosamond WD, Folsom AR. ABO blood group, other risk factors and incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE). J Thromb Haemost 2007; 5:1455-61. [PMID: 17425663 DOI: 10.1111/j.1538-7836.2007.02579.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Numerous case-control studies have reported higher prevalence of non-O blood type among venous thromboembolism (VTE) patients than controls, but potential mechanisms or effect modifiers for the association are not fully established. PATIENTS/METHODS Using a nested case-control design combining the Atherosclerosis Risk in Communities and the Cardiovascular Health Study cohort, ABO blood type and other VTE risk factors were measured on pre-event blood samples of 492 participants who subsequently developed VTE and 1008 participants who remained free of VTE. RESULTS A total of 64.4% of cases and 52.5% of controls had non-O blood type. Among controls, mean values of factor VIIIc (FVIIIc) and von Willebrand factor among the non-O blood type group were higher than among the O group. Compared with O blood type, the age-adjusted odds ratio (OR) of VTE for non-O blood type was 1.64 (95% CI, 1.32-2.05) and was similar for the two parent studies and race groups. Further adjustment for sex, race, body mass index, diabetes mellitus and FVIIIc reduced the OR: 1.31 (95% CI, 1.02-1.68). Factor V Leiden (FV Leiden) appeared to modify the non-O blood type association with VTE in a supra-additive fashion, with an age-, sex- and race-adjusted OR of 6.77 (95% CI, 3.65-12.6) for having both risk factors. CONCLUSIONS Non-O blood type was independently associated with risk of VTE, and added to the risk associated with FV Leiden.
Collapse
Affiliation(s)
- T Ohira
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454-1015, USA
| | | | | | | | | | | | | | | |
Collapse
|
15
|
|
16
|
Schleef M, Strobel E, Dick A, Frank J, Schramm W, Spannagl M. Relationship between ABO and Secretor genotype with plasma levels of factor VIII and von Willebrand factor in thrombosis patients and control individuals. Br J Haematol 2005; 128:100-7. [PMID: 15606555 DOI: 10.1111/j.1365-2141.2004.05249.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In contrast to earlier reports, this study examined the relationship between plasma levels of factor VIII (FVIII) and von Willebrand factor (VWF) and ABO blood group and secretor status at the genetic level in 355 patients with venous thrombosis as well as in 236 controls. ABO glycosyl transferase alleles A(1) and B were more frequent in the thrombosis collective and alleles O(1), O(2) and A(2) were more frequent in the controls. A low-risk group for venous thrombosis of individuals with genotypes O(1)O(1), O(1)O(2) and O(1)A(2) (H-antigen rich) could be distinguished from a high-risk group with genotypes A(1)A(1), A(1)B, O(1)A(1) and O(1)B (H-antigen poor). In both the thrombosis and control groups, the H-antigen rich group showed significantly lower levels of FVIII coagulant activity (FVIII:C) and VWF antigen (VWF:Ag) than the H-antigen poor group. The frequency of the different secretor genotypes in the thrombosis group was not different from that in the control group. No significant differences of FVIII:C and VWF:Ag levels were seen between SeSe, Sese and sese individuals in the thrombosis and in the control group. Thus the risk of venous thrombosis is associated with the ABO blood group genotype but not with secretor status.
Collapse
Affiliation(s)
- Michael Schleef
- Abteilung für Transfusionsmedizin und Hämostaseologie, Klinikum der Ludwig-Maximilians-Universität München, Munich, Germany.
| | | | | | | | | | | |
Collapse
|
17
|
Carter YM, Caps MT, Meissner MH. Deep venous thrombosis and ABO blood group are unrelated in trauma patients. THE JOURNAL OF TRAUMA 2002; 52:112-6. [PMID: 11791060 DOI: 10.1097/00005373-200201000-00019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although epidemiologic studies of the general population have demonstrated a deficit of blood group O among patients with deep venous thrombosis (DVT), few studies have evaluated the importance of blood group in high-risk patients. The purpose of this study was to evaluate the importance of ABO blood group as a thrombotic risk factor in injured patients. METHODS Injured patients with a discharge diagnosis of DVT were identified from an institutional trauma registry and compared with control patients matched for age and Injury Severity Score. ABO blood types of patients and controls were obtained from the regional blood center database. RESULTS Three hundred forty-three case-control pairs were identified from a total of 401 consecutive cases of DVT. Blunt injury was the predominant mechanism of injury, accounting for 90.4% of cases. Chest (p = 0.01) and extremity (p < 0.001) Abbreviated Injury Scale scores were independent predictors of DVT. However, there was no significant difference in blood group distribution or the A to O ratio between patients with and without DVT. For non-type O patients, the odds ratio for developing DVT was 1.1 (95% confidence interval, 0.8-1.5; p = 0.5) in comparison with type O patients. CONCLUSION These data do not support a clinically relevant association between blood type and DVT in trauma patients. Injury-associated derangements of coagulation may be more important than any hypercoagulability related to blood type in this population.
Collapse
Affiliation(s)
- Yvonne M Carter
- Division of Vascular Surgery, Harborview Medical Center, Seattle, Washington, USA
| | | | | |
Collapse
|