Blood group B and decreased risk of coronary artery disease in hypertensive elderly.
Grupo sanguíneo B y disminución del riesgo de enfermedad arterial coronaria en ancianos hipertensos.
Abstract
Although ABO blood groups have been associated with cardiovascular disease, little is known about whether ABO blood groups contribute to the risk of the presence and severity of coronary artery disease (CAD) in elderly individuals with hypertension. This study was aimed to explore this association. A total of 793 hypertensive patients aged ≥60 years out of 2095 patients who underwent primary coronary angiography were retrospectively included. They were divided into CAD and non-CAD groups. Demographic and clinical characteristics, ABO blood groups and other biochemical parameters were compared. Further evaluation was performed to determine the impact of ABO blood groups on CAD severity using the Gensini score and the number of significantly diseased vessels. A logistic regression model was constructed to identify the association of ABO blood groups with CAD. There was a substantial difference in the distribution of ABO blood groups in elderly and hypertensive adults with and without CAD (p=0.022). Hypertensive patients with CAD had a significantly lower proportion of the blood group B than those without CAD (p=0.008). Compared to those with non-Blood group B, hypertensive elderly with a blood group B tended to have significantly lower concentrations of TC, LDL-C and Apo B, and a lower number of significantly stenosed vessels. The blood group B was found to be an independent protective factor for CAD in elderly with hypertension. The blood group B is significantly associated with a decreased risk of CAD and is inversely correlated with the severity of coronary stenosis in the elderly with hypertension.
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GBD 2017 Causes of Death CollABOrators. Global, regional, and national agesex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the global burden of disease study 2017. Lancet 2018; 392(10159): 1736-1788. https://doi.org/10.1016/s0140-6736(18)32203-7.
Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. EurHeart J 2014; 35(42): 2950-2959. https://doi.org/10.1093/eurheartj/ehu299.
Rosamond W, Flegal K, Furie K, Go A, Greenlund K, Haase N, Hailpern SM, HoM, Howard V, Kissela B, Kittner S, Lloyd-Jones D, McDermott M, Meigs J, Moy C, Nichol G, O’Donnell C, Roger V, Sorlie P, Steinberger J, Thom T, Wilson M, Hong Y. Heart disease and stroke statistics—2008 update: a report from the American heart association statistics committee and stroke statistics subcommittee. Circulation 2008; 117(4): e25-e146. https://doi.org/10.1161/circulationaha.107.187998.
Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, Deaton C, Escaned J, Hammes HP, Huikuri H, Marre M, Marx N, Mellbin L, Ostergren J, Patrono C, Seferovic P, Uva MS, Taskinen MR, Tendera M, Tuomilehto J, Valensi P, Zamorano JL, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, De Backer G, Sirnes PA, Ezquerra EA, Avogaro A, Badimon L, Baranova E, Baumgartner H, Betteridge J, Ceriello A, Fagard R, Funck-Brentano C, Gulba DC, Hasdai D, Hoes AW, Kjekshus JK, Knuuti J, Kolh P, Lev E, Mueller C, Neyses L, Nilsson PM, Perk J, Ponikowski P, Reiner Z, Sattar N, Schächinger V, Scheen A, Schirmer H, Strömberg A, Sudzhaeva S, Tamargo JL, Viigimaa M, Vlachopoulos C, Xuereb RG. ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collABOration with the EASD: the task force on diabetes, pre-diabetes, and cardiovascular diseases of the European society of cardiology (ESC) and developed in collABOration with the European association for the study of diabetes (EASD). EurHeart J 2013; 34(39): 3035-3087. https://doi.org/10.1093/eurheartj/eht108.
Lee JS, Chang PY, Zhang Y, Kizer JR, Best LG, Howard BV. Triglyceride and HDL-C dyslipidemia and risks of coronary heart disease and ischemic stroke by glycemic dysregulation status: the strong heart study. Diabetes Care 2017; 40(4): 529-537. https://doi.org/10.2337/dc16-1958.
Gong P, Luo SH, Li XL, Guo YL, Zhu CG, Xu RX, Li S, Dong Q, Liu G, Chen J, Zeng RX, Li JJ. Relation of ABO blood groups to the severity of coronary atherosclerosis: an Gensini score assessment. Atherosclerosis 2014; 237(2): 748-753 https://doi.org/10.1016/j.atherosclerosis.2014.10.107.
Carpeggiani C, Coceani M, Landi P, Michelassi C, L’Abbate A. ABO blood group alleles: a risk factor for coronary artery disease. An angiographic study. Atherosclerosis 2010; 211(2): 461-466. https://doi.org/10.1016/j.atherosclerosis. 2010.03.012.
Biswas J, Islam MA, Rudra S, Haque MA, Bhuiyan ZR, Husain M, Mamun AA. Relationship between blood groups and coronary artery disease. Mymensingh Med J 2008; 17(2 Suppl): S22-S27. https://doi. org/10.12968/bjon.2008.17.Sup1.28146.
Biswas S, Ghoshal PK, Halder B, Mandal N. Distribution of ABO blood group and major cardiovascular risk factors with coronary heart disease. Biomed Res Int 2013; 2013: 782941. https://doi. org/10.1155/2013/782941.
Liu M, Ji S, Xu W, Liu W, Qin Y, Xiang J, Hu Q, Sun Q, Zhang Z, Xu X, Yu X. ABO blood group and the risk of pancreatic neoplasms in Chinese Han population: a study at Shanghai pancreatic cancer institute. Pancreas 2019; 48(9): e65-e66. https://doi. org/10.1097/mpa.0000000000001408.
Zindovic I, Edgren G, Nozohoor S, Majeed ABO blood group and the risk of aortic disease: a nationwide cohort study. BMJ Open 2020; 10(10): e036040. https://doi. org/10.1136/bmjopen-2019-036040.
Jing W, Zhao S, Liu J, Liu M. ABO blood groups and hepatitis B virus infection: a systematic review and meta-analysis. BMJ Open 2020; 10(1): e034114. https://doi. org/10.1136/bmjopen-2019-034114.
Abrignani MG, Aiello A, Colivicchi F, Lucà F, Fattirolli F, Gulizia MM, Nardi F, Pino PG, Gregorio G. Prevenzione cardiovascolare negli anziani: limiti e opportunità [Cardiovascular prevention in the elderly: limitations and opportunities]. G Ital Cardiol (Rome) 2020; 21(8): 619-628. https:// doi.org/10.1714/3405.33896.
Chan MY, Woo KS, Wong HB, Chia BL, Sutandar A, Tan HC. Antecedent risk factors and their control in young patients with a first myocardial infarction. Singapore Med J 2006; 47(1): 27-30.
Zimmerman FH, Cameron A, Fisher LD, Ng G. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). J Am Coll Cardiol 1995; 26(3): 654-661. https://doi. org/10.1016/0735-1097(95)00254-2.
Incalcaterra E, Caruso M, Lo Presti R, Caimi G. Myocardial infarction in young adults: risk factors, clinical characteristics and prognosis according to our experience. Clin Ter 2013; 164(2): e77-e82. https://doi. org/10.7417/ct.2013.1535.
Lee HF, Lin YC, Lin CP, Wang CL, Chang CJ, Hsu LA. Association of blood group A with coronary artery disease in young adults in Taiwan. Intern Med 2012; 51(14): 1815-1820. https://doi.org/10.2169/internalmedicine.51.7173.
Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983; 51(3): 606. https://doi.org/10.1016/ s0002-9149(83)80105-2.
Dean L. Blood groups and red cell antigens. Bethesda (MD): National Center for Biotechnology Information; 2005.
Franchini M, Mannucci PM. ABO blood group and thrombotic vascular disease. Thromb Haemost 2014; 112(6): 1103-1109. https://doi.org/10.1160/th14-05-0457.
Franchini M, Capra F, Targher G, Montagnana M, Lippi G. Relationship between ABO blood group and von Willebrand factor levels: from biology to clinical implications. Thromb J 2007; 5: 14. https://doi. org/10.1186/1477-9560-5-14.
Vasan SK, Rostgaard K, Majeed A, Ullum H, Titlestad KE, Pedersen OB, Erikstrup C, Nielsen KR, Melbye M, Nyrén O, Hjalgrim H, Edgren G. ABO blood group and risk of thromboembolic and arterial disease: a study of 1.5 million blood donors. Circulation 2016; 133(15): 1449-1457; discussion 1457. https://doi.org/10.1161/ circulationaha.115.017563.
Groot HE, Villegas Sierra LE, Said MA, Lipsic E, Karper JC, Van Der Harst P. Genetically determined ABO blood group and its associations with health and disease. Arterioscler Thromb Vasc Biol 2020; 40(3): 830-838. https://doi.org/10.1161/atvbaha.119.313658.
Pourafkari L, Ghaffari S, Ahmadi M, Tajlil A, Nader ND. Association of ABO blood types with the risk of instent restenosis. Perfusion 2015; 30(6): 507-513. https://doi. org/10.1177/0267659115573098.
Karabuva S, Carević V, Radić M, Fabijanić D. The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease. Biochem Med (Zagreb) 2013; 23(3): 351-359. https://doi. org/10.11613/bm.2013.043.
Sari I, Ozer O, Davutoglu V, Gorgulu S, Eren M, Aksoy M. ABO blood group distribution and major cardiovascular risk factors in patients with acute myocardial infarction. Blood Coagul Fibrinolysis 2008; 19(3): 231-234. https://doi.org/10.1097/ MBC.0b013e3282f54522.
Biancari F, Satta J, Pokela R, Juvonen T. ABO blood group distribution and severity of coronary artery disease among patients undergoing coronary artery bypass surgery in Northern Finland. Thromb Res 2002; 108(2-3): 195-196. https://doi. org/10.1016/s0049-3848(03)00003-3.
Hoiland RL, Fergusson NA, Mitra AR, Griesdale DEG, Devine DV, Stukas S, Cooper J, Thiara S, Foster D, Chen LYC, Lee AYY, Conway EM, Wellington CL, Sekhon MS. The association of ABO blood group with indices of disease severity and multiorgan dysfunction in COVID-19. Blood Adv 2020; 4(20): 4981-4989. https://doi. org/10.1182/bloodadvances.2020002623.
Murray GP, Post SR, Post GR. ABO blood group is a determinant of von Willebrand factor protein levels in human pulmonary endothelial cells. J Clin Pathol 2020; 73(6): 347-349. https://doi.org/10.1136/jclinpath-2019-206182.
Koncsos P, Fülöp P, Juhász I, Bíró K, Márk L, Simonyi G, Paragh G. Changes in triglyceride, HDL-C, and non-HDL-C levels in patients with acute coronary syndrome. Wien Klin Wochenschr 2016; 128(23-24): 858-863. https://doi.org/10.1007/s00508-016-1035-4.
Stein R, Ferrari F, Scolari F. Genetics, dyslipidemia, and cardiovascular disease: new insights. Curr Cardiol Rep 2019; 21(8): 68. https://doi.org/10.1007/s11886-019-1161-5.
Seo SM, Choo EH, Koh YS, Park MW, Shin DI, Choi YS, Park HJ, Kim DB, Her SH, Lee JM, Park CS, Kim PJ, Moon KW, Chang K, Kim HY, Yoo KD, Jeon DS, Chung WS, Park YG, Seung KB. High-density lipoprotein cholesterol as a predictor of clinical outcomes in patients achieving low-density lipoprotein cholesterol targets with statins after percutaneous coronary intervention. Heart 2011; 97(23): 1943-1950. https:// doi.org/10.1136/hrt.2011.225466.
Schmitz G, Kaminski WE. ABCA2: a candidate regulator of neural transmembrane lipid transport. Cell Mol Life Sci 2002; 59(8): 1285-1295. https://doi.org/10.1007/s00018-002-8508-5.
Chen Y, Chen C, Ke X, Xiong L, Shi Y, Li J, Tan X, Ye S. Analysis of circulating cholesterol levels as a mediator of an association between ABO blood group and coronary heart disease. Circ Cardiovasc Genet 2014; 7(1): 43-48. https://doi.org/10.1161/circgenetics.113.000299.
Gong P, Li S, Hu L, Luo S, Li J, Jiang H. Total cholesterol mediates the effect of ABO blood group on coronary heart disease. Zhonghua Xin Xue Guan Bing Za Zhi 2015; 43(5): 404-407.
Silbernagel G, Chapman MJ, Genser B, Kleber ME, Fauler G, Scharnagl H, Grammer TB, Boehm BO, Mäkelä KM, Kähönen M, Carmena R, Rietzschel ER, Bruckert E, Deanfield JE, Miettinen TA, Raitakari OT, Lehtimäki T, März W. High intestinal cholesterol absorption is associated with cardiovascular disease and risk alleles in ABCG8 and ABO: evidence from the LURIC and YFS cohorts and from a meta-analysis. J Am Coll Cardiol 2013; 62(4): 291-2 https:// doi.org/10.1016/j.jacc.2013.01.100.