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AB0血型:对人工机械瓣膜血栓形成的影响。

AB0 blood types: impact on development of prosthetic mechanical valve thrombosis.

作者信息

Astarcıoğlu Mehmet Ali, Kalçık Macit, Yesin Mahmut, Gürsoy Mustafa Ozan, Şen Taner, Karakoyun Süleyman, Gündüz Sabahattin, Özkan Mehmet

机构信息

Department of Cardiology, Evliya Çelebi Training and Research Hospital; Kütahya-Turkey.

Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital; İstanbul-Turkey.

出版信息

Anatol J Cardiol. 2016 Nov;16(11):820-823. doi: 10.14744/AnatolJCardiol.2016.6544. Epub 2016 Jul 21.

Abstract

OBJECTIVE

The non-O alleles of the ABO genotype have been associated with an increased risk of thrombosis. We aimed to assess the association between blood group status and prosthetic valve thrombosis.

METHODS

The association between AB0 blood group status and prosthetic valve thrombosis was assessed in this retrospective study. Transesophageal echocardiography was performed in 149 patients with a diagnosis of prosthetic valve thrombosis and in 192 control subjects.

RESULTS

Non-0 blood group type (p<0.001), presence of NYHA class III-IV status (p<0.001), and central nervous system (p<0.001) and non-central nervous system (p<0.001) emboli were significantly more prevalent in prosthetic valve thrombosis patients than in the control subjects. The incidence of ineffective anticoagulation was higher in patients with prosthetic valve thrombosis than in controls (p<0.001), as was the presence of moderate to severe left atrial spontaneous echo contrast (p<0.001). The non-0 blood prosthetic valve thrombosis subgroup had a higher incidence of obstructive thrombi and central nervous system thrombotic events than having 0 blood prosthetic valve thrombosis subgroup. Non-0 blood group, ineffective anticoagulation, left atrial spontaneous echo contrast, and a poor NYHA functional capacity were identified to be the predictors of prosthetic valve thrombosis.

CONCLUSION

Our data demonstrate that patients with non-0 compared with 0 blood groups have higher incidence of prosthetic valve thrombosis and central nervous system embolism and similar rates of non-central nervous system embolism at presentation compared with 0 blood group type. Thus, non-O blood group may be a risk factor that may be prone to the development of prosthetic valve thrombosis in patients with prosthetic heart valves.

摘要

目的

ABO基因型的非O等位基因与血栓形成风险增加有关。我们旨在评估血型状态与人工瓣膜血栓形成之间的关联。

方法

在这项回顾性研究中评估ABO血型状态与人工瓣膜血栓形成之间的关联。对149例诊断为人工瓣膜血栓形成的患者和192例对照者进行经食管超声心动图检查。

结果

人工瓣膜血栓形成患者中非O血型(p<0.001)、纽约心脏协会(NYHA)III-IV级状态(p<0.001)以及中枢神经系统(p<0.001)和非中枢神经系统(p<0.001)栓塞的发生率明显高于对照者。人工瓣膜血栓形成患者无效抗凝的发生率高于对照组(p<0.001),中度至重度左心房自发显影的发生率也是如此(p<0.001)。非O血型人工瓣膜血栓形成亚组阻塞性血栓和中枢神经系统血栓事件的发生率高于O血型人工瓣膜血栓形成亚组。非O血型、无效抗凝、左心房自发显影和NYHA功能能力差被确定为人工瓣膜血栓形成的预测因素。

结论

我们的数据表明,与O血型相比,非O血型患者人工瓣膜血栓形成和中枢神经系统栓塞的发生率更高,与O血型相比,就诊时非中枢神经系统栓塞的发生率相似。因此,非O血型可能是人工心脏瓣膜患者发生人工瓣膜血栓形成的一个易患危险因素。

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