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Non-O blood groups associated with higher risk of heart attack
Having a non-O blood group is associated with a higher risk
of heart attack, according to research presented recently at
Heart Failure 2017 and the 4th World Congress on Acute Heart
Failure.
Lead author Tessa Kole, a Master’s degree student at the
University Medical Centre Groningen, the Netherlands, said: ‘It
has been suggested that people with non-O blood groups (A, B,
AB) are at higher risk for heart attacks and overall cardiovascular
mortality, but this suggestion comes from case–control studies,
which have a low level of evidence. If this was confirmed, it could
have important implications for personalised medicine.’
The current study was a meta-analysis of prospective
studies reporting on O and non-O blood groups, and incident
cardiovascular events, including myocardial infarction (heart
attack), coronary artery disease, ischaemic heart disease, heart
failure, cardiovascular events and cardiovascular mortality.
The study included 1 362 569 subjects from 11 prospective
cohorts, described in nine articles. There were a total of 23 154
cardiovascular events. The researchers analysed the association
between blood group and all coronary events, combined
cardiovascular events and fatal coronary events.
The analysis of all coronary events included 771 113 people
with a non-O blood group and 519 743 people with an O
blood group, of whom 11 437(1.5%) and 7 220 (1.4%) suffered
a coronary event, respectively. The odds ratio (OR) for all
coronary events was significantly higher in carriers of a non-O
blood group, at 1.09 [95% confidence interval (CI) of 1.06–1.13].
The analysis of combined cardiovascular events included 708
276 people with a non-O blood group and 476 868 people with
an O blood group, of whom 17 449 (2.5%) and 10 916 (2.3%)
had an event, respectively. The OR for combined cardiovascular
events was significantly higher in non-O blood group carriers, at
1.09 (95% CI 1.06–1.11).
The analysis of fatal coronary events did not show a
significant difference between people with O and non-O blood
groups.
‘We demonstrate that having a non-O blood group is
associated with a 9% increased risk of coronary events and a
9% increased risk of cardiovascular events, especially myocardial
infarction’, said Ms Kole.
The mechanisms that might explain this risk are under
study. The higher risk for cardiovascular events in non-O blood
group carriers may be due to having greater concentrations of
von Willebrand factor, a blood clotting protein which has been
associated with thrombotic events. Further, non-O blood group
carriers, specifically those with an A blood group, are known
to have higher cholesterol. And galectin-3, which is linked to
inflammation and worse outcomes in heart failure patients, is
also higher in those with a non-O blood group.
Ms Kole said: ‘More research is needed to identify the cause
of the apparent increased cardiovascular risk in people with a
non-O blood group. Obtaining more information about risk in
each non-O blood group (A, B and AB) might provide further
explanations of the causes.’
She concluded: ‘In future, blood group should be considered
in risk assessment for cardiovascular prevention, together with
cholesterol, age, sex and systolic blood pressure. It could be that
people with an A blood group should have a lower treatment
threshold for dyslipidaemia or hypertension, for example. We
need further studies to validate if the excess cardiovascular risk
in non-O blood group carriers may be amenable to treatment.’
Source:
European Society of Cardiology Press Office