Association of ABO histo-blood group B allele with myocardial infarction

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 O Protect End-Stage Renal Disease Patients With Dialysis From Coronary Artery Disease

Objective

Our study aims to investigate the role of the ABO blood group in the development and severity of coronary artery disease (CAD) in end-stage renal disease (ESRD) patients with dialysis.

Methods

A total of 408 ESRD patients with dialysis between January 2010 and December 2020 were enrolled including 204 patients diagnosed with CAD undergoing coronary angiography for the first time, and baseline characteristics as well as Gensini score (GS) were collected. Logistic regression analysis and linear regression analysis were performed to evaluate the relation of ABO blood types to the risk and severity of CAD, respectively.

Results

Blood group O frequency was significantly low in dialysis ESRD patients with CAD (25 vs. 38.24%) compared with the non-CAD patients and multivariable logistic regression showed blood group O was negatively associated with the risk of CAD [adjusted odds ratio (OR) = 0.33, 95% CI = 0.19–0.60, p < 0.001] as well as the GS tertiles (adjusted OR = 0.23, 95% CI = 0.11–0.49, p < 0.001) compared with A blood group. Blood group A, B, and AB were positively associated with the high Gensini tertile compared with O blood group (adjusted OR = 4.26, 95% CI = 2.03–8.93, p < 0.001; adjusted OR = 2.39, 95% CI = 1.11–5.13, p < 0.05; adjusted OR = 4.33, 95% CI = 1.40–13.35, P < 0.05). Similarly, multivariable linear regression results revealed O blood type was negatively associated with the GS (β = −26.129, 95% CI = −40.094 to −12.164, p < 0.001).

Conclusion

This case-control study demonstrated that blood group O was a potential independent protective factor for the risk and severity of CAD in ESRD patients with dialysis.

The association between ABO blood groups and TASC II classification in patients with peripheral artery disease

OBJECTIVE

The aim of this study was to investigate the association between blood groups and severity of peripheral artery disease (PAD) using TASC II classification.

METHODS

The patients who were diagnosed with PAD were retrospectively analyzed. The patients with 50% or more stenosis in the aorto-iliac or femoro-popliteal region detected by conventional or CT angiography were included in the study. These patients were divided into TASC II A, B, C, and D groups considering the severity of PAD. All patients' blood groups were recorded and compared between TASC II groups.

RESULTS

While 38% of the study population was O blood group, 61% were non-O group. On the other hand, 90% of the entire study population were RH positive and 10% were RH negative. Non-O blood ratio was found to be significantly higher in patients with higher TASC II groups. (TASC IIA 51.6% vs. TASC IIB 57.9% vs. TASC IIC 61.3% vs. TASC IID 76.6%, p< .001) However, the frequencies of Rh types were similar in all groups. Multiple logistic regression analysis was applied for determining the predictors of severity and complexity of PAD (TASC II C and TASC II D lesions).

CONCLUSIONS

Our study results revealed a clear association between ABO blood groups and severity of peripheral arterial disease. Non-O blood group was found to be the independent predictor of severe and complex PAD.

Association of ABO blood groups with the severity of coronary artery disease: a cross-sectional study

Objective

To investigate whether ABO blood groups is associated with the severity of coronary artery disease (CAD).

Methods

Between January 2015 and December 2017, 1425 first diagnosed CAD patients confirmed by selective coronary angiography were recruited into this cross-sectional study, and their baseline characteristics, ABO blood groups, Gensini score were collected. Multiple linear regression analysis was performed to test the association between the severity of CAD and ABO blood groups.

Results

The Gensini score was significantly higher in the blood group A than in the non-A groups (41.2 ± 32 vs. 38 ± 27; P = 0.026). After adjusting for age, male, smoking, family history of CAD, hypertension, diabetes mellitus and hypercholesterolemia, multivariate linear regression indicated that blood group A was associated with the severity of CAD (β = 3.298, 95% CI: 0.91–6.505, P = 0.044). In diabetes group, A blood type was also associated with increased Gensini score (P = 0.02) after adjusting for age, male, family history of CAD, hypercholesterolemia, smoking and hypertension.

Conclusion

In this cross-sectional study, the data indicated that blood group A was an independent risk factor of severity of CAD in Chinese population and Chinese patients with type 2 diabetes.

Coronary Heart Disease and ABO Blood Group in Diabetic Women: A Case-Control Study

Numerous investigations conducted in general population have reported that certain ABO blood group may increase the risk of coronary heart disease (CHD). However, this association has not been yet well established and even is less clear in diabetic patients. Considering that women with type 2 diabetes mellitus (T2DM) are at greater risk to develop CHD and have higher cardiovascular mortality, this study aimed to evaluate the association between CHD and ABO blood group in women with T2DM. A case control study of eight hundred eighty-one (881) diabetic women was enrolled in this study. Among them, two hundred thirty eight (238) patients were identified to have CHD (CHD+) and two hundred eighty two (282) of them were identified without CHD but matched with the first group for other CHD risk factors (CHD-). ABO blood type (A, B, AB, O, and Rhesus factor) for both groups were determined. To compare the magnitude of the correlation between various blood groups with CHD development, odd ratios (OR) with 95% confidence intervals (CI) was calculated. Our results demonstrates that the percentage of AB blood group was significantly higher in the diabetic women with concurrent CHD than in those without CHD [30 (12.7%) vs. 13 (4.6%), Odd ratio: 2.9 (95%CI: 1.5-5.7), P = 0.001]. The results of the present study clearly demonstrate that the AB blood group has a higher odd ratio for the development of CHD and can be considered as a risk factor for the development of CHD in females with T2DM. More comprehensive studies are required to confirm these results.

Is there an association between ABO blood grouping and periodontal disease? A literature review

Introduction

Although several studies have investigated the relationship between ABO blood group and medical diseases, few reports have explored the association with oral diseases, including periodontal disease (PD).

Aim

The aim of this literature review was to assess the association between the ABO blood grouping and PD.

Methods

We searched PubMed and Google Scholar databases using the following terms in different combinations: “ABO blood group,” “periodontitis,” “aggressive periodontitis (AP),” “risk factor,” and “Rhesus factor.” Databases were searched for articles published from 1977 to August 2016. Titles and abstracts of articles were screened for English-language papers describing clinical studies, case reports, or retrospective studies of oral health status in patients with different ABO blood groups. Letters to the editor, historic reviews, and articles including unpublished data were excluded. Reference lists of included studies were reviewed for additional original and review studies.

Results

We identified eight articles describing studies of the relationship between ABO blood groups and PD. The findings suggested a possible genetic basis in the association of the blood group AB with AP. Four studies showed that chronic periodontitis was more common among patients with blood group O.

Conclusion

ABO blood subgroup and Rhesus factor could constitute risk predictors in the development of PD.

Correlation of ABO Blood Group Phenotype and Rhesus Factor with Periodontal Disease: An Observational Study

Background:

The knowledge of the ABO blood group phenotype of the patients and their correlation with the periodontal disease maybe important in the development of early treatment strategies, and it would be helpful to target non-responding areas to periodontal therapy of the susceptible individuals.

Aims:

The present study was conducted to determine whether there was any correlation between periodontal diseases and ABO blood groups and Rh factor.

Material and Method:

This study was carried out on 537 subjects attending Faculty of Dental Sciences OPD in BHU. Subjects were divided into three groups: group I (healthy subjects), group II (subjects with gingivitis), and group III (subjects with periodontitis) based on periodontal examination (Gingival index, Bleeding Index, Probing pocket depth and clinical attachment level). ABO Blood grouping were done and correlated with the periodontal status of study subjects. Statistical Analysis: Data was analyzed using the statistical software namely Statistical Package for the Social Sciences (SPSS, Version 16, IBM Analytics) and Systat 8.0.

Results:

In this study, there was a greater prevalence of gingivitis in blood group O and periodontitis in blood group B. The blood group AB showed the least prevalence of periodontal diseases. Similarly gingivitis and peridontitis were significantly higher among Rhesus positive groups when compared with Rhesus negative groups.

Conclusion:

Considering the results of this study, it can be concluded that ABO blood groups and Rh factor could be a risk factor for the development of periodontal disease.

The association between blood group and the risk of vascular disease in Quebec blood donors

BACKGROUND

The association between antigens A and B and arterial thrombosis, such as coronary heart disease, cerebrovascular disease or peripheral vascular disease, is still unclear. We evaluated the association between blood groups and thrombotic events in a cohort of blood donors from the province of Quebec, Canada.

MATERIAL AND METHODS

Among all whole blood donors aged ≥18 years in Quebec between June 1990 and March 2009, a study sample with known blood groups was linked with the provincial hospitalisation and death records to count vascular events. All hospital admissions and deaths with codes for primary and relevant secondary diagnoses of coronary, cerebrovascular or peripheral diseases, including coronary heart disease interventions, were included. Cox regression was used to evaluate the hazard ratio associated between blood groups and these events adjusted for other baseline characteristics.

RESULTS

Among the blood donors, 64,686 had a known blood group and were linked with the provincial health databases. The mean age of these donors was 38 years. The Cox multivariate adjusted hazard ratio for coronary, cerebrovascular or peripheral diseases was 1.19 (95% confidence interval: 1.01-1.40) for subjects with blood group AB compared to those with blood group O. There were no statistically significant associations with other blood groups. Only among women aged ≥40 years did those with blood group A have a higher hazard ratio for coronary heart disease (1.40 [1.01-1.92]) than those with blood group O, after adjusting for other characteristics.

DISCUSSION

When compared to blood group O, only blood group AB was associated with a higher risk of hospitalisation or death because of thrombotic events such as coronary, cerebrovascular or peripheral diseases. However, the associations differed according to age and sex because only females aged ≥40 years with blood group A had a higher risk of coronary heart disease.

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.

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.

Caries and ABO secretor status in a Hungarian population of children and adolescents: an exploratory study

ABO blood group antigen (ABGA) secretion into the saliva and other body fluids is a well-known phenomenon, and there is evidence to suggest a link between secretor status and the appearance of caries. It has been proposed that secretion of these antigens into the saliva might be caries-preventive, however, this proposition is still a matter of debate. Our aim was to examine the relationship between caries experience and secretor status in a group of Hungarian children and adolescents in a cross-sectional study. Altogether 130 children and adolescents participated in the study (aged 6-18 years). Participants were divided into two groups according to dentition (i.e. mixed and permanent). ABGA were determined from saliva. The DMF-T and dmf-t (decayed, missing, and filled) indices were calculated, as well as the oral health hygiene index-simplified plaque index. Association of these indices with secretor status was examined. In mixed dentition, the mean dmf-t values were significantly lower in the secretor group (2.1 ± 0.52 SEM), as compared to the nonsecretor group (3.8 ± 0.93 SEM; p < 0.05, Mann-Whitney U test). The finding that children of mixed dentition are apparently better protected against caries suggests that the assumed protective effect might be associated with deciduous teeth, but given the general paucity of knowledge about this topic, further research is indicated.

ABO Blood Groups and Cardiovascular Diseases

ABO blood groups have been associated with various disease phenotypes, particularly cardiovascular diseases. Cardiovascular diseases are the most common causes of death in developed countries and their prevalence rate is rapidly growing in developing countries. There have been substantial historical associations between non-O blood group status and an increase in some cardiovascular disorders. Recent GWASs have identified ABO as a locus for thrombosis, myocardial infarction, and multiple cardiovascular risk biomarkers, refocusing attention on mechanisms and potential for clinical advances. As we highlight in this paper, more recent work is beginning to probe the molecular basis of the disease associations observed in these observational studies. Advances in our understanding of the physiologic importance of various endothelial and platelet-derived circulating glycoproteins are elucidating the mechanisms through which the ABO blood group may determine overall cardiovascular disease risk. The role of blood group antigens in the pathogenesis of various cardiovascular disorders remains a fascinating subject with potential to lead to novel therapeutics and prognostics and to reduce the global burden of cardiovascular diseases.

ABO-Rh blood groups distribution in cardiac syndrome X patients

Background:

Data on frequency distribution of ABO-Rh blood groups in cardiac syndrome X (CSX) patients are not available. We aimed to investigate the distribution of ABO-Rh blood groups in these patients.

Materials and Methods:

A total of 247 CSX patients’ records were reviewed in a cross-sectional study from 2006 to 2010. One hundred forty six patients (59.1%) were female, and the mean patient age was 52 ± 11 years. The frequency of ABO-Rh blood groups was compared to the frequency of these blood groups in the West-Azerbaijan province, Iran; general population.

Results:

Blood groups distribution among CSX patients showed phenotypes A, B, AB, O and Rh negative as 33.1%, 21.9%, 9.3%, 35.8%, and 7.9%, respectively. According to our results, there were no differences in ABO-Rh blood groups distribution between CSX patients and normal population.

Conclusion:

These data suggest that ABO-Rh blood groups might be unassociated with CSX.

Association of blood group A with coronary artery disease in young adults in Taiwan

OBJECTIVE

We aimed to investigate the association between the ABO blood groups and the risk of coronary artery disease (CAD) and myocardial infartion (MI) in a young Taiwanese population.

METHODS

We retrospectively recruited 277 consecutive subjects (men younger than 45 years and women younger than 55 years) who underwent coronary angiography (136 with documented CAD and 129 without CAD) at our center, between 2005 and 2008. Their ABO blood groups were determined using standard agglutination techniques.

RESULTS

Patients with CAD showed a significantly different blood group distribution (O, 30.1%; A, 39.7%; B, 26.5%; AB, 3.7%) than that shown by the controls (O, 42.6%; A, 24.0%; B, 27.1%; AB, 6.2%; p=0.032). Patients with blood group A had a greater risk of CAD and MI than those with non-A blood groups (OR=2.08, 95% CI=1.23-3.54; OR=2.21, 95% CI=1.19-4.09, respectively). After adjustment for common cardiovascular risk factors such as age, gender, hypertension, cigarette smoking, diabetes mellitus, body mass index, family history of CAD, and lipid profiles; blood group A remained significantly associated with an increased risk of CAD and MI (OR=2.61, 95% CI 1.11-6.14, p=0.028; OR=3.53, 95% CI=1.21-10.29, p=0.021, respectively).

CONCLUSION

Our findings suggest that blood group A is an independent risk factor for CAD and MI in young people in Taiwan.

Distribution of ABO and Rh blood groups in Greece: an update

The aim of this study was to investigate and evaluate the frequency of the antigens classifying the ABO and Rh blood groups in the Greek population. In this study the 3.5% were first generation immigrants with both their parents immigrants from countries of the USSR, while 1.2% had only one immigrant parent, while the other one was Greek. We compared the frequency of distribution of blood groups ABO and Rh to previous studies conducted at a time before Greece became destination for refugees and immigrants from East and Northeast countries. Blood samples were collected from first year medical students. The frequency of distribution of the ABO and Rh blood groups was slightly differentiated in comparison to previous relevant studies. Significant increase was recorded with respect to the emergence of blood group B in the population investigated, and a considerable reduction was noted in blood group O. In reference to the remaining blood groups, no statistically significant difference was documented. The genetic pool and the genetic inventory of the population residing in Greece have been modified during the last years potentially due to the first generation immigrants. The results of this study could contribute significantly to the National Health System in aiding the prediction of percussions of certain diseases related to blood groups, as well as the requirement for certain blood groups within the blood donation program.

ABO blood group alleles: A risk factor for coronary artery disease. An angiographic study

OBJECTIVES

To analyze the impact of ABO groups on coronary heart disease risk factors, coronary involvement and prognosis.

METHODS

An observational single center study was conducted to examine 4901 consecutive patients with heart disease receiving coronary angiography and ABO group determination at National Research Council Institute of Clinical Physiology between January 1993 and December 2003, with maximum 10 years follow-up. All-cause death and cardiac death, were the considered end points.

RESULTS

When compared to the official distribution of ABO groups in the Italian population (O 40%, A 36%, B 17%, AB 7%), a substantially different distribution was observed in the study population (O 43.3%, A 41.4%, B 11.2%, AB 4.1%). In addition, a significant association was found between group non-O and family history of ischemic heart disease, hypercholesterolemia and presence of coronary atherosclerosis. Higher prevalence of A and B alleles was found in patients with myocardial infarction (P<0.05). Group non-O was a powerful predictor of cardiac mortality in patients aged <65 years, particularly in women (HR 1.53, 95% CI 1.06-2.21 and HR 5.29, 95% CI 1.57-17.82, respectively).

CONCLUSIONS

Group non-O is associated with increased mortality in patients with ischemic heart disease. Group non-O increases the risk for cardiac death in non-elderly patients, particularly in younger females, and groups A and B prevail in myocardial infarction. ABO group determination might aid in genetic screening for ischemic heart disease and become relevant in the management of risk factor control.

ABO blood groups and genetic risk factors for thrombosis in Croatian population

AIM

To assess the association between ABO blood group genotypes and genetic risk factors for thrombosis (FV Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations) in the Croatian population and to determine whether genetic predisposition to thrombotic risk is higher in non-OO blood group genotypes than in OO blood group genotypes.

METHODS

The study included 154 patients with thrombosis and 200 asymptomatic blood donors as a control group. Genotyping to 5 common alleles of ABO blood groups was performed by polymerase chain reaction with sequence specific primers (PCR-SSP). FV Leiden was determined by PCR-SSP, while prothrombin and methylenetetrahydrofolate reductase were determined by PCR and restriction fragment length polymorphism (PCR-RFLP).

RESULTS

There was an association between non-OO blood group genotypes and the risk of thrombosis (odds ratio [OR] 2.08, 95% confidence interval [CI], 1.32-3.27). The strongest association with thrombotic risk was recorded for A1B/A2B blood group genotypes (OR, 2.73; 95% CI, 1.10-6.74), followed by BB/O1B/O2B (OR, 2.29; 95% CI, 1.25-4.21) and O1A1/O2A1 (OR, 1.95; 95% CI, 1.15-3.31). FV Leiden increased the risk of thrombosis 31-fold in the group of OO carriers and fourfold in the group of non-OO carriers. There was no significant difference in the risk of thrombosis between OO and non-OO blood groups associated with prothrombin mutation. Non-OO carriers positive for methylenetetrahydrofolate reductase had a 5.7 times greater risk of thrombosis than that recorded in OO carriers negative for methylenetetrahydrofolate reductase.

CONCLUSION

Study results confirmed the association of non-OO blood group genotypes with an increased risk of thrombosis in Croatia.

Large-scale genomic studies reveal central role of ABO in sP-selectin and sICAM-1 levels

P-selectin and intercellular adhesion molecule-1 (ICAM-1) participate in inflammatory processes by promoting adhesion of leukocytes to vascular wall endothelium. Their soluble levels have been associated with adverse cardiovascular events. To identify loci affecting soluble levels of P-selectin (sP-selectin) and ICAM-1 (sICAM-1), we performed a genome-wide association study in a sample of 4115 (sP-selectin) and 9813 (sICAM-1) individuals of European ancestry as a part of The Cohorts for Heart and Aging Research in Genome Epidemiology consortium. The most significant SNP association for sP-selectin was within the SELP gene (rs6136, P = 4.05 x 10(-61)) and for sICAM-1 levels within the ICAM-1 gene (rs3093030, P = 3.53 x 10(-23)). Both sP-selectin and sICAM-1 were associated with ABO gene variants (rs579459, P = 1.86 x 10(-41) and rs649129, P = 1.22 x 10(-15), respectively) and in both cases the observed associations could be accounted for by the A1 allele of the ABO blood group. The absence of an association between ABO blood group and platelet-bound P-selectin levels in an independent subsample (N = 1088) from the ARIC study, suggests that the ABO blood group may influence cleavage of the P-selectin protein from the cell surface or clearance from the circulation, rather than its production and cellular presentation. These results provide new insights into adhesion molecule biology.

ABO genotype and risk of thrombotic events and hemorrhagic stroke

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.

ABO blood group distribution and major cardiovascular risk factors in patients with acute myocardial infarction

We aimed to investigate whether there is an association between ABO blood groups, cardiovascular risk factors and myocardial infarction (MI) in a Turkish cohort. Four hundred and seventy-six patients with acute ST elevation MI (mean age 56.7+/-11.7; 80% men) and 203 age and sex matched healthy subjects were enrolled in the study. ABO blood group distribution of patients was compared with control group. Furthermore, in each ABO blood group, frequency of major cardiac risk factors was determined to find any correlation between blood groups and cardiovascular risk factors. The distribution of ABO blood groups in patients versus control group was A in 43.1 versus 44.3%, B in 15.1 versus 15.3%, AB in 10.7 versus 12.3% and O in 31.1 versus 28.1% (P>0.05 for all). ABO blood group distribution of both patients and control group was concordant with the official data from general Turkish population. The frequency of cardiovascular risk factors was similar in patients with different blood groups; however, the patients with blood group A were younger (P=0.004) and coronary artery disease detection age was lower (P=0.001) than those with the other blood groups. The distribution of ABO blood groups in patients with MI was quite similar to that in control group and that of general Turkish population, which supports the idea that ABO blood group might not be significantly associated with the development of MI. Association of ABO blood group distribution with cardiovascular risk factors, coronary artery disease and MI needs to be clarified with multicenter, prospective and large-scale studies.

Inherited Thrombophilia in Arterial Disease: A Selective Review

Thrombophilia may be defined as an acquired or congenital abnormality of hemostasis predisposing to thrombosis. Because arterial thrombosis is usually linked with classical risk factors such as smoking, hypertension, dyslipidemia, or diabetes, a thrombophilia workup is usually not considered in case of arterial thrombosis. The most accepted inherited hemostatic abnormalities associated with venous thromboembolism are factor V Leiden (FVL) and factor II (FII) G20210A mutations, as well as deficiencies in antithrombin (AT), protein C (PC), and protein S (PS). This review focuses on the link between these abnormalities and arterial thrombosis. Overall, the association between these genetic disorders and the three main arterial complications (myocardial infarction [MI], ischemic stroke [IS], and peripheral arterial disease [PAD]) is modest. Routine screening for these disorders is therefore not warranted in most cases of arterial complications. However, when such an arterial event occurs in a young person, inherited abnormalities of hemostasis seem to play a role, particularly when associated with smoking or oral contraceptive use. These abnormalities also seem to play a role in the risk of premature occlusion after revascularization procedures. Therefore thrombophilia tests may be informative in a very restricted population with arterial events. Anticoagulants rather than antiplatelet therapy may be preferable for these patients, although this remains to be proven.

Histo-blood group antigens as allo- and autoantigens

The science of blood groups has made giant steps forward during the last decade. Blood-group typing of red blood cells (RBCs) is performed on more than 15 million samples per year in Europe, today much less often for forensic reasons than for clinical purposes such as transfusion and organ transplantation. Specific monoclonal antibodies are used with interpretation on the basis of RBC agglutination patterns, and mass genotyping may well be on its way to becoming a routine procedure. The discovery that most blood group systems, whose antigens are by definition found on RBCs, are also expressed in multiple other tissues has sparked the interest of transplantation medicine in immunohematology beyond the HLA system. The one and only "histo-blood group" (HBG) system that is routinely considered in transplantation medicine is ABO, because ABO antigen-incompatible donor/recipient constellations are preferably avoided. However, other HBG systems may also play a role, thus far underestimated. This paper is an up-to-date analysis of the importance of HBG systems in the alloimmunity of transplantation and autoimmune events, such as hemolytic anemia.

Correlation between ABO blood groups, major risk factors, and coronary artery disease

To investigate a possible association of ABO blood groups with coronary artery disease in well-documented patients, we designed a cross-sectional study of 2026 patients, known case of coronary artery disease in angiography, who underwent coronary artery bypass graft at Tehran Heart Center, with regard to coronary artery disease major risk factors as well as ABO blood groups. Analysis did not show any significant difference between the frequency of ABO blood groups in coronary artery disease patients compared to the Iranian general population. In addition, frequency of cardiac risk factors was similar in coronary artery disease patients with different blood groups. Therefore, these finding suggest that there is no correlation between various ABO blood groups and development of coronary artery disease. Moreover, the prevalence of major risk factors was equal in patients with different blood groups, and blood groups had no impact on development of premature coronary artery disease in individual subjects.