ABO Blood Group and Vascular Disease: An Update.
ABSTRACT It has been well known for many years that the ABO blood group has a major influence on hemostasis, through its influence on von Willebrand factor and, consequently, factor VIII plasma levels. Although the relationship between non-O blood type and the risk of venous thromboembolism is nowadays also well established, the association with arterial thrombotic events (i.e., myocardial infarction [MI] and ischemic stroke) is less well characterized. To elucidate the latter issue, we have conducted a systematic review and meta-analysis of the existing literature. After an electronic search strategy using MEDLINE and EMBASE and a manual review of abstract books of the International Society on Thrombosis and Haemostasis and of reference lists of all retrieved articles, 28 studies were finally included in our systematic review. The prevalence of non-O blood group was significantly higher in patients with MI (pooled odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.17-1.40; p < 0.001) and ischemic stroke (pooled OR: 1.17, 95% CI: 1.01-1.35; p = 0.03) than in controls. The restriction of the analysis to high quality studies only confirmed the association with MI (pooled OR: 1.17, 95% CI: 1.03-1.32) but not with ischemic stroke (pooled OR: 1.28, 95% CI: 0.94-1.74). In conclusion, the results of our meta-analysis confirm the existing literature evidence of a weak association between non-O blood group and vascular arterial thrombosis, in particular myocardial ischemia.
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ABSTRACT: Other than being present at the surface of red blood cells, the antigens of the ABO blood group system are efficiently expressed by a variety of human cells and tissues. Several studies recently described the involvement of the ABO blood group in the pathogenesis of many human disorders, including cardiovascular disease and cancer, so that its clinical significance extends now beyond the traditional boundaries of transfusion medicine. In a large cohort study recently published in BMC Medicine and including over 50,000 subjects, Etemadi and colleagues reported that nearly 6% of total deaths and as many as 9% of cardiovascular deaths could be attributed to having non-O blood groups, a condition that was also found to be associated with increased risk of gastric cancer. In this commentary, the clinical implications of ABO blood groups are critically discussed and a possible common pathogenic mechanism involving the von Willebrand factor is described.BMC Medicine 01/2015; 2015(13):7. · 7.28 Impact Factor
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ABSTRACT: Over a period of almost a century, many have attempted to find a relationship between ABO blood group and predisposition to certain diseases (e.g., pernicious anaemia, gastric cancer, pancreatic cancer, venous thrombosis, coronary heart disease, duodenal ulcer) 1, 2 . The ABO blood group system is the most important blood type system in human blood transfusion. The antigens of the ABO system (A, B, and H determinants, respectively) consist of complex carbohydrate molecules. The A and B alleles encode slightly different glycosyltransferases that add N-acetylgalactosamine and D-galactose, respectively, to a common precursor side chain, the H determinant, and convert it into A or B antigens. The O alleles do not encode a functional enzyme and consequently OO carriers, who lack the transferase enzymes, continue to express the basic, unmodified, H structure, which has a solitary terminal fucose moiety attached 3 . The ABO blood group certainly has a profound influence on haemostasis. The most well-known is the major quantitative effects that the ABO blood group exerts on plasma levels of von Willebrand Factor (vWF) and consequently of factor VIII (FVIII), since vWF acts as a specific carrier of FVIII and protects it from proteolytic degradation 2 . The ABO blood group locus on chromosome 9q34 is the most important genetic determinant of plasma levels of the vWF-FVIII complex after the vWF (12p12) and F8 (Xq28) genes. Indeed, plasma vWF levels are 25-35% lower in subjects with O blood group than in individuals with non-O blood group. Several investigators have studied the clinical implications of this biological interaction, including the influence of the ABO blood group on the risk of developing bleeding or thrombotic events 2,4,5Blood transfusion = Trasfusione del sangue 12/2014; · 1.90 Impact Factor