Januszkiewicz Łukasz, Szczerba Ewa, Paszkowska Paulina, Cacko Andrzej, Grabowski Marcin, Sierdziński Janusz, Styś Adam, Filipiak Krzysztof J, Opolski Grzegorz
Pol Arch Med Wewn. 2013;123(9):460-6. doi: 10.20452/pamw.1885. Epub 2013 Jul 4.
Multiple factors that affect the prognosis of acute coronary syndromes (ACS) have been identified. There are scarce data on the effect of the blood group on prognosis in this patient group.
We investigated the effect of ABO and Rh (D antigen) status on the prognosis of ACS.
A group of 418 consecutive hospitalized patients with ACS were analyzed. The follow‑up period was 2075 ±794 days. The primary endpoint was all‑cause mortality. A statistical analysis was performed for the following subgroups: ABO blood group, ABO blood group including Rhesus (Rh) factor (D antigen), Rh‑positive vs. Rh‑negative blood group, O blood group vs. non‑0 blood group, blood group with vs. without the B antigen, and blood group with vs. without the A antigen.
A total of 348 patients (83.25%) were Rh-positive, while 70 (16.75%) were Rh‑negative. The Kaplan-Meier survival plots showed 7‑year mortality of 22.7% in patients with blood groups with Rh antigen and of 10% in patients without Rh antigen (P = 0.014). Other comparisons were not statistically significant. A multivariable Cox proportional hazards model identified blood group with D antigen as an independent predictor of mortality (hazard ratio, 7.758; 95% confidence interval, 1.748-34.417; P = 0.007).
Of all blood groups, only the Rh‑positive blood group was an independent predictor of mortality in patients with ACS.
目前已确定多种影响急性冠状动脉综合征(ACS)预后的因素。关于血型对该患者群体预后影响的数据较少。
我们研究了ABO血型和Rh(D抗原)状态对ACS患者预后的影响。
分析了一组418例连续住院的ACS患者。随访期为2075±794天。主要终点是全因死亡率。对以下亚组进行了统计分析:ABO血型、包括恒河猴(Rh)因子(D抗原)的ABO血型、Rh阳性与Rh阴性血型、O型血与非O型血、有B抗原与无B抗原的血型、有A抗原与无A抗原的血型。
共有348例患者(83.25%)为Rh阳性,70例(16.75%)为Rh阴性。Kaplan-Meier生存曲线显示,有Rh抗原血型患者的7年死亡率为22.7%,无Rh抗原患者的死亡率为10%(P = 0.014)。其他比较无统计学意义。多变量Cox比例风险模型确定有D抗原的血型是死亡率的独立预测因素(风险比,7.758;95%置信区间,1.748 - 34.417;P = 0.007)。
在所有血型中,只有Rh阳性血型是ACS患者死亡率的独立预测因素。