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It is increasingly being recognized that ABO blood groups are associated with increased risks of venous thromboembolism (VTE) and arterial disease. However, it is unclear if the risk elevation among non-O blood group carriers is solely a direct effect or may also be mediated through increased risks of other diseases.
This was an observational study of 7830 patients (5533 males and 2297 females) who presented to our department between May 2015 and October 2016 based on medical record review from an electronic clinical information system in our hospital. Detailed information of patients were collected, including age, sex, blood type and history of comorbidity, such as hypertension, diabetes mellitus, hyperlipemia, atrial fibrillation, VTE, pulmonary embolism (PE), myocardial infarction (MI), stroke, etc. Multivariate logistic regression analyses were used to evaluate the association between ABO blood groups and VTE, pulmonary embolism and myocardial infarction.
7830 patients were enrolled in this study, with 28.4% of patients with A blood group, 32.7% with B blood group, 11.0% with AB blood group and 27.9% with O blood group. In those 7830 patients, the risk of VTE was higher for patients with A blood group (OR = 2.161, 95%CI 1.101-4.239, P = 0.025) compared with O blood group, after adjustment for age, sex, hypertension, diabetes mellitus (DM), hyperlipemia, atrial fibrillation (AF), hyperthyroidism, hypothyroidism, obstructive sleep apnea (OSA), coronary artery disease (CAD), MI, cardiomyopathy, stroke, etc. A blood group increased risk of VTE in women only (OR = 3.770, 95%CI 1.034-13.747, P = 0.044) on univariate analysis. In addition, A blood group was associated with the risk of PE (OR=3.051, 95%CI 1.406-6.625, P = 0.005). After the stratification of age and sex, increased risk of PE was noted in age (range, 40-59 yrs) (OR = 2.892, 95%CI 1.005-8.325, P = 0.049) and male (OR = 2.680, 95%CI 1.018-7.056, P = 0.046) in the A blood group compared with the O blood group. In those 6713 patients with rheumatic heart disease, cardiomyopathy, myocarditis, constrictive pericarditis, or valvular heart disease excluded, A blood group was associated with the risk of PE (OR = 1.303, 95%CI 1.124-1.511, P<0.001). In A blood group, age (range, 40-59 yrs) (OR = 1.404, 95%CI 1.144-1.724, P = 0.001) and male (OR = 1.316, 95%CI 1.117-1.551, P = 0.001) only tended to increase the risk of MI.
Individuals with an A blood type have an increased risk of venous thromboembolism, pulmonary embolism and myocardial infarction compared with individuals with O blood type. ABO blood group may have a role in thrombosis risk assessment and could potentially be added to available clinical prediction systems.