ABO blood groups and the risk of venous thrombosis in patients with inherited thrombophilia

Association Between ABO Blood Group and Venous Thromboembolism Risk in Patients With Peripherally Inserted Central Catheters: A Meta-analysis and Systematic Review

Background

Previous studies have evaluated the association between ABO blood group and venous thromboembolism (VTE) risk in patients with peripherally inserted central catheters (PICCs). However, it remains unclear whether ABO blood groups are associated with PICC-associated VTE risk. Therefore, we conducted a meta-analysis of related studies to elucidate the potential role of ABO blood group as a risk factor for PICC-associated VTE.

Methods

All detectable case-control and cohort studies comparing the role of ABO blood group as a risk factor for PICC-associated VTE were collected for this analysis by searching PubMed, Embase, CNKI, Web of Science, and Wanfang. We conducted a meta-analysis of the eligible studies and computed the summary risk estimates with random or fixed effects models.

Results

A total of four studies involving 7,804 patients were included. Meta-analysis of the studies showed that the risk of PICC-associated VTE was significantly higher in blood types A [odds ratio (OR)=1.54, 95% CI=1.17-2.03), p=0.002], B (OR=2.35, 95% CI=1.71-3.23, p<0.0001), and AB (OR=2.55, 95% CI=1.68-3.88, p<0.0001) and lower in blood types O (OR=0.58, 95% CI=0.45-0.74, p<0.0001). Subgroup analysis based on ethnicity demonstrated that blood type O may be a genetic protective factor for PICC-associated VTE in Asians. Among Caucasians, individuals with blood types B and AB have a higher risk of PICC-associated VTE. Blood types A, B, and AB are risk factors for PICC-associated VTE in Asians.

Conclusions

Blood type O is associated with a decreased risk of PICC-associated VTE, especially in Asian populations. Moreover, blood types A, B, and AB are risk factors for PICC-associated VTE.

Correlation between an ABO Blood Group and Primary Femoral Head Necrosis: A Case-Control Study

Objective

To investigate the relationship between primary femoral head necrosis (ONFH) and an ABO blood group.

Methods

This study was a retrospective case–control trial. An analysis of the clinical data of an ABO blood group with 516 patients (case group) with ONFH and 489 limb‐fracture patients (control group) without previous hip pain was obtained from the Second Hospital of Shanxi Medical University from November 2015 to November 2018. The clinical data included gender, age, height, weight, a history of smoking, alcohol abuse, prior medical history, hormone use, and ABO blood type. A logistic regression model was used for univariate and multivariate analysis.

Results

From November 2015 to November 2018, there were 267 males and 249 females in the 516 cases of ONFH in the case group. The control group included 289 males and 200 females. In terms of age, the average age of the case group was significantly lower than that of the control group. In terms of body mass index (BMI), the BMI of the case group was significantly higher than that of the control group (P < 0.05). From the previous medical history of patients in the two groups (coronary heart disease, hypertension, cerebrovascular disease, diabetes, and peripheral vascular disease), there was no significant difference between the two groups from a statistical perspective (P < 0.05). However, according to the risk factors of ONFH (smoking, alcohol abuse, hyperlipidemia, and hormone‐use history), there were significant differences between the case group and the control group. There was no statistical difference in the quantitative distribution ratio of the four blood types – A, B, O, and AB – between the case group and the control group. The outcomes of logistic multiple regression analysis presented that there was no significant correlation between the occurrence of ONFH and blood type A, B, AB, and O (P > 0.05). However, there are significant differences in the disease progression between the different blood types. There was a significant difference in the progression of disease between type A and type O. Among them, patients with ONFH and type A blood had the fastest progression with an average of 2.318 years, and the slowest progression was found in type O blood with an average of 5.15 years.

Conclusions

The ABO blood group has no correlation with the occurrence of ONFH, but the ABO blood type is closely related to the disease progression of ONFH.

Impact of blood group on survival following critical illness: a single-centre retrospective observational study

Background

Predicting patient outcomes following critical illness is challenging. Recent evidence has suggested that patients with blood group AB are more likely to survive following major cardiac surgery, and this is associated with a reduced number of blood transfusions. However, there are no current data to indicate whether a patient’s blood group affects general intensive care outcomes.

Objective

The objective of this study was to determine if ABO blood group affects survival in intensive care. The primary outcome measure was 90-day mortality with a secondary outcome measure of the percentage of patients receiving a blood transfusion.

Design

Retrospective analysis of electronically collected intensive care data, blood group and transfusion data.

Setting

General intensive care unit (ICU) of a major tertiary hospital with both medical and surgical patients.

Patients

All patients admitted to ICU between 2006 and 2016 who had blood group data available.

Intervention

None.

Measurements and main results

7340 patients were included in the study, blood group AB accounted for 3% (221), A 41% (3008), B 10.6% (775) and O 45.4% (3336). These values are similar to UK averages. Baseline characteristics between the groups were similar. Blood group AB had the greatest survival benefit (blood group AB 90-day survival estimate 76.75, 95% CI 72.89 to 80.61 with the overall estimate 72.07, 95% CI 71.31 to 72.82) (log-rank χ² 16.128, p=0.001). Transfusion requirements were similar in all groups with no significant difference between the percentages of patients transfused (AB 23.1%, A 21.5%, B 18.7%, O 19.9%, Pearson χ² 5.060 p=0.167).

Conclusion

Although this is primarily a hypothesis generating study, intensive care patients with blood group AB appeared to have a higher 90-day survival compared with other blood groups. There was no correlation between blood group and percentage of patients receiving transfusion.

Inherited thrombophilia in unprovoked venous thromboembolism: Is non 'O' blood group an additional culprit in Indian patients?

BACKGROUND

Venous thromboembolism (VTE) is a known situation of considerable mortality and morbidity and occurs due to the convergence of multiple acquired and genetic risk factors.

METHODS

In this study, we have comprehensively analyzed the effect of ABO blood groups and inherited thrombophilia factors [Protein C (PC), Protein S (PS), Antithrombin III (AT III), Activated Protein C Resistance (APCR) and Homocysteine (Hcy)] on 150 unprovoked VTE patients, comparing with normal healthy controls. ABO phenotyping was done using gel cards and thrombophilia workup done using standard kits on coagulation autoanalyzer.

RESULTS

Non O blood group was significantly more frequent among cases than controls (77.3% vs. 62.7%) and had higher odds of VTE (OR = 2.03, 95%CI: 1.22-3.37).Positivity for at least one marker of thrombophilia was more in cases (40%) than controls (16%), and led to significantly higher odds (OR = 3.5, 95%CI: 2.03-6.04) of VTE. Deficiency of PS was the commonest thrombophilia abnormality.Combination of non O group with positivity for thrombophilia markers was also more among cases (OR = 5.67, 95%CI: 2.76-11.65). Highest odds of VTE in cases were associated with non O group in combination with increased Homocystein (OR = 10.8, 95%CI: 2.27-51.5).

CONCLUSION

The study results show non O blood group and positivity for factors of inherited thrombophilia in cases impart higher odds of VTE individually. Also combination of both non O blood group and positivity for factors of inherited thrombophilia in cases further increases the odds of VTE. This awareness could assist physicians in identifying those at higher risk of VTE and tailor-made the thromboprophylaxis accordingly.

Increased Vasoocclusive Crises in "O" Blood Group Sickle Cell Disease Patients: Association with Underlying Thrombospondin Levels

Objectives

To explore the incidence of vaso-occlusive crisis (VOC) in Blood Group “O” sickle cell disease (SCD) patients, and correlate it with the blood group and thrombospondin (TSP) levels.

Methods

In 89 consecutive SCD patients, blood samples were obtained for von Williebrand factor (vWF:Ag) antigen, collagen binding activity (CBA), ristocetin binding activity (RCo), blood group typing, C-reactive protein (CRP), high performance liquid chromatography (HPLC), Serum TSP 1 and TSP 2 levels, complete blood counts (CBC), lactic dehydrogenase (LDH) levels, liver function (LFT) and renal function tests (RFT) during VOC episodes and in steady state conditions.

Results

In steady state SCD patients (n=72), “O” blood group patients (n=37) showed a significantly higher median serum TSP 1 and TSP 2 levels as compared to non-O blood group patients [n=35] [p <0.05, Mann-Whitney test]; with an inverse relation between vWF:Ag, Factor VIII:C and TSP levels. Furthermore, the serum TSP 1 and TSP 2 levels were significantly higher in patients presenting with acute VOC [n=17], as well as in those with repeated VOC’s (group 1, n=16), especially amongst blood group “O” patients [p, <0.05, Mann-Whitney test].

Conclusions

The study demonstrates an inverse relation between TSP and vWF levels, in blood group “O” SCD patients, with an upregulation of the TSP levels. Expectedly, during active VOC crisis, the TSP 1 and TSP 2 levels were significantly elevated.

ABO blood groups and risk of deep venous thromboembolism in Chinese Han population from Chaoshan region in South China

 Objectives: To demonstrate the prevalence of ABO blood groups with deep venous thromboembolism in Chinese Han population.

METHODS

A retrospective study was conducted between January 2010 and March 2015 in The First Affiliated Hospital of Shantou University Medical College in Chaoshan District of Guangdong Province in South China. Eighty nine patients with confirmed diagnosis of deep venous thromboembolism were included. Frequency of blood groups was determined. Results: Of 89 patients with deep venous thromboembolism, 28 patients had blood group A (31.5%), 28 patients had blood group B (31.5%), 13 patients had blood group AB (14.6%), and 20 patients had blood group O (22.5%). Compared with O blood type, the odds ratios of deep venous thromboembolism for A, B and AB were 2.23 (95% CI, 1.27-3.91), 2.34 (95% CI, 1.34-4.09) and  4.43 (95% CI, 2.24-8.76). Conclusion: There is a higher risk of venous thromboembolism in non-O blood groups than O group.

A genetic risk factor for thrombophilia in a Han Chinese family

Thrombophilia is a multifactorial disorder involving environmental and genetic factors. Well‑known factors that result in predisposition to congenital disorders associated with thrombophilia include antithrombin deficiency, protein C and S deficiency, Factor V Leiden mutation, abnormal prothrombin and antiphospholipid syndrome. The present study revealed an association between a mutation of the F2 gene, which codes for coagulation factor II, thrombin, and the risk of thrombophilia in a Han Chinese family, of which four members (I‑2, II‑2, II‑3 and III‑1) had a history of deep venous thromboembolism. The disease was measured in this family using laboratory measurements and computed tomography angiography. To identify the abnormality underlying the increased thrombophilia risk, whole‑exome sequencing technology was used to analyze two affected individuals (II‑2 and III‑1). An exonic missense F2 mutation, T165M (NM_000506:c.C494T:p.T165M;rs5896), was identified from a total of 2,222 and 2,203 genetic variations observed in the two affected individuals, respectively, which were subsequently filtered and confirmed using Sanger sequencing. I‑2, II‑3 and III‑1 shared this mutation with the proband (II‑2), and II‑6 had a heterozygous form of the mutation. This deleterious mutation was not identified in normal controls. The present study may improve understanding of the function of the F2 gene.