Capuzzo Enrico, Bonfanti Carlo, Frattini Francesco, Montorsi Paolo, Turdo Rosalia, Previdi Maria Grazia, Turrini Elisa, Franchini Massimo
1 Department of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantova, Italy ; 2 AVIS Provinciale, Mantova, Italy.
Ann Transl Med. 2016 May;4(10):189. doi: 10.21037/atm.2016.03.58.
The ABO blood group exerts a profound influence on hemostasis, and it has hence been associated with the development of thrombotic cardiovascular adverse events. In this study, we evaluated the relationship between the ABO blood group and the risk of cardiovascular disease assessed with the Cardiorisk score.
All blood donors aged between 35 and 65 years were enrolled in the Cardiorisk program, which included the assessment of 8 variables (sex, age, total cholesterol, high-density lipoprotein (HDL) cholesterol, plasma glucose, arterial blood pressure, anti-hypertensive therapy and smoking) which were used to generate a score. Individuals with a resulting score ≥20, considered at high cardiovascular risk, underwent additional instrumental tests (chest X-ray, stress electrocardiogram and Doppler ultrasound of supra-aortic trunks) and were closely clinically monitored.
Between January 2005 and December 2015, 289 blood donors with Cardiorisk ≥20 were identified, 249 of whom were included in the study with at least 2 years of follow-up. Among these, 36 (14.5%) had instrumental abnormality tests and developed adverse cardiovascular events (10 acute coronary syndrome, 2 cerebral ischemia, 3 cardiac arrhythmia, 8 stenosis of supra-aortic trunks or iliac arteries) during a median follow-up of 5.3 years. In this group of 249 high risk individuals, a statistically significant association (P=0.02) was found between the non-O blood type and the risk of developing subclinical or clinical cardiovascular events (odds ratio, 3.3; 95% CI, 1.1-10.1; P=0.033).
The results of this study underline the both key role of ABO blood group for the risk of developing arterial thrombotic events and the need for including such unmodifiable variable on the scores assessing the thrombotic risk.
ABO血型对止血有深远影响,因此与血栓性心血管不良事件的发生有关。在本研究中,我们评估了ABO血型与用心脏风险评分评估的心血管疾病风险之间的关系。
所有年龄在35至65岁之间的献血者均纳入心脏风险项目,该项目包括对8个变量(性别、年龄、总胆固醇、高密度脂蛋白(HDL)胆固醇、血浆葡萄糖、动脉血压、抗高血压治疗和吸烟)进行评估,这些变量用于生成一个评分。得分≥20的个体被认为心血管风险高,需接受额外的器械检查(胸部X光、应激心电图和主动脉弓多普勒超声)并进行密切的临床监测。
在2005年1月至2015年12月期间,确定了289名心脏风险≥20的献血者,其中249名纳入研究并至少随访2年。在这些人中,36名(14.5%)器械检查异常并在中位随访5.3年期间发生心血管不良事件(10例急性冠状动脉综合征、2例脑缺血、3例心律失常、8例主动脉弓或髂动脉狭窄)。在这249名高危个体中,发现非O血型与发生亚临床或临床心血管事件的风险之间存在统计学显著关联(P = 0.02)(优势比,3.3;95%CI,1.1 - 10.1;P = 0.033)。
本研究结果强调了ABO血型在动脉血栓形成事件风险中的关键作用,以及在评估血栓形成风险的评分中纳入此类不可改变变量的必要性。