From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
Circulation. 2016 Apr 12;133(15):1449-57; discussion 1457. doi: 10.1161/CIRCULATIONAHA.115.017563. Epub 2016 Mar 3.
ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies.
We used the SCANDAT2 (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987 and 2012 were followed up for diagnosis of thromboembolism and arterial events. Poisson regression models were used to estimate incidence rate ratios as measures of relative risk. A total of 9170 venous and 24 653 arterial events occurred in 1 112 072 individuals during 13.6 million person-years of follow-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis (incidence rate ratio, 1.92; 95% confidence interval, 1.80-2.05), and pulmonary embolism (incidence rate ratio, 1.80; 95% confidence interval, 1.71-1.88).
In this healthy population of blood donors, non-O blood groups explain >30% of venous thromboembolic events. Although ABO blood groups may potentially be used with available prediction systems for identifying at-risk individuals, its clinical utility requires further comparison with other risk markers.
ABO 血型与静脉血栓栓塞和动脉疾病的风险增加有关。然而，这种关联的报道规模不一致，并且基于小规模研究的证据。
我们使用了丹麦和瑞典的献血者的 SCANDAT2（斯堪的纳维亚捐赠和输血）数据库，该数据库与其他全国性健康数据登记册相关联，以调查 ABO 血型与首次和复发性静脉血栓栓塞和动脉事件之间的关联。1987 年至 2012 年期间，丹麦和瑞典的献血者在随访期间接受了血栓栓塞和动脉事件的诊断。泊松回归模型用于估计发病率比率作为相对风险的度量。在 1360 万人年的随访中，在 112072 名个体中发生了 9170 例静脉和 24653 例动脉事件。与血型 O 相比，非 O 血型与静脉和动脉血栓栓塞事件的发生率较高相关。妊娠相关静脉血栓栓塞症（发病率比，2.22；95%置信区间，1.77-2.79）、深静脉血栓形成（发病率比，1.92；95%置信区间，1.80-2.05）和肺栓塞（发病率比，1.80；95%置信区间，1.71-1.88）观察到最高的率比。
在这个健康的献血者人群中，非 O 血型解释了超过 30%的静脉血栓栓塞事件。尽管 ABO 血型可能与现有的预测系统一起用于识别高危个体，但它的临床实用性需要与其他风险标志物进一步比较。
