ABO Kan Grubu ve Koroner Arter Hastalığı Riski ve Şiddeti: Çok Yöntemli Analitik Çerçeveden Elde Edilen Kanıtlar

Öz

Amaç: ABO kan grupları ile koroner arter hastalığı (KAH) arasındaki ilişki kapsamlı bir şekilde araştırılmış, ancak bulgular tutarsız kalmıştır. Bu çalışma, bu ilişkiyi anjiyografik olarak doğrulanmış KAH'da çoklu tamamlayıcı analitik yaklaşımlar kullanarak değerlendirmeyi amaçlamıştır. Gereç ve Yöntem: Bu retrospektif olgu-kontrol çalışmasına, anjiyografik olarak doğrulanmış KAH'lı 1.305 hasta ve 1.165 kontrolden oluşan toplam 2.470 katılımcı dahil edilmiştir. ABO kan grupları ile KAH arasındaki ilişki düzeltilmemiş lojistik regresyon, kardiyovasküler risk faktörleri için düzeltilmiş çok değişkenli lojistik regresyon ve eğilim skoru eşleştirmesi (ESE) kullanılarak değerlendirilmiştir. Cinsiyet, yaş ve diabetes mellitus durumuna göre alt grup analizleri etkileşim testleriyle birlikte yapılmıştır. Hastalık şiddeti Gensini skoru kullanılarak değerlendirilmiştir. Bulgular: ABO kan grubu dağılımı KAH hastaları ile kontroller arasında anlamlı farklılık göstermemiştir (p=0,212). Üç analitik yaklaşımın hiçbirinde anlamlı ilişki saptanmamıştır: tek değişkenli (genel p=0,215), çok değişkenli (genel p=0,304) veya ESE analizi (genel p=0,324). Alt grup analizleri ve etkileşim testleri cinsiyet, yaş veya diyabet durumu tarafından anlamlı etki modifikasyonu tespit etmemiştir. Gensini skorları KAH hastaları arasında ABO kan gruplarına göre anlamlı farklılık göstermemiştir (p=0,259). Sonuç: ABO kan grupları ile KAH'ın varlığı veya şiddeti arasında anlamlı bir ilişki bulunamamıştır. Bu bulgu, üç tamamlayıcı analitik yaklaşım boyunca tutarlılık göstermiştir. Bu çalışma, çelişkili sonuçların devam ettiği literatürdeki bir alana kapsamlı bir analitik çerçeveye dayalı kanıt sunmaktadır.

Anahtar Kelimeler

• ABO kan grubu
• Ateroskleroz
• Eğilim skoru eşleştirmesi
• Gensini skoru
• Koroner arter hastalığı

Etik Beyan

Bu çalışma, Amasya Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Tarih: 06.02.2025, Karar No: 2024/185).

ABO Blood Group and Coronary Artery Disease Risk and Severity: Evidence from a Multi-Method Analytical Framework

Öz

Objective: The association between ABO blood groups and coronary artery disease (CAD) has been extensively investigated, yet findings remain inconsistent. This study aimed to evaluate this association in angiographically confirmed CAD using multiple complementary analytical approaches. Materials and Methods: This retrospective case-control study enrolled 2,470 participants, comprising 1,305 patients with angiographically confirmed CAD and 1,165 controls. The association between ABO blood groups and CAD was assessed using unadjusted logistic regression, multivariable logistic regression adjusted for cardiovascular risk factors, and propensity score matching (PSM). Subgroup analyses stratified by sex, age, and diabetes mellitus status were performed with interaction testing. Disease severity was evaluated using the Gensini score. Results: ABO blood group distribution did not differ significantly between CAD patients and controls (p=0.212). No significant association between ABO blood groups and CAD was identified in any of the three analytical approaches: univariable (overall p=0.215), multivariable (overall p=0.304), or PSM analysis (overall p=0.324). Subgroup analyses and interaction tests detected no significant effect modification by sex, age, or diabetes status. Gensini scores did not differ significantly across ABO blood groups among CAD patients (p=0.259). Conclusion: No significant association was found between ABO blood groups and the presence or severity of CAD. This finding was consistent across three complementary analytical approaches. This study provides evidence based on a comprehensive analytical framework in an area of the literature where conflicting results persist.

Anahtar Kelimeler

• ABO blood group
• Atherosclerosis
• Coronary artery disease
• Gensini score
• Propensity score matching

Etik Beyan

This study was approved by the Amasya University Non-Interventional Clinical Research Ethics Committee (Date: 06.02.2025, Decision No: 2024/185).

Kaynakça

1. Naghavi M, Ong KL, Aali A, et al. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2100-2132.
2. Kominato Y, Sano R, Takahashi Y, Hayakawa A, Ogasawara K. Human ABO gene transcriptional regulation. Transfusion. 2020;60(4):860-869.
3. O’Donghaile D, Jenkins PV, McGrath RT, et al. Expresser phenotype determines ABO(H) blood group antigen loading on platelets and von Willebrand factor. Sci Rep. 2020;10(1):18366.
4. Gong P, Luo SH, Li XL, et al. Relation of ABO blood groups to the severity of coronary atherosclerosis: An Gensini score assessment. Atherosclerosis. 2014;237(2):748-753.
5. Hong XL, Li Y, Fu GS, et al. Association of ABO blood groups with the severity of coronary artery disease: A cross-sectional study. J Geriatr Cardiol. 2019;16(9):701-705.
6. Amirzadegan A, Salarifar M, Sadeghian S, Davoodi G, Darabian C, Goodarzynejad H. Correlation between ABO blood groups, major risk factors, and coronary artery disease. Int J Cardiol. 2006;110(2):256-258.
7. Tabesh F, Sadeghi M, Soleimani A, et al. Blood group types and clinical, procedural, and adverse outcomes in ST-elevated myocardial infarction patients: A 3-year cohort in Iran. J Res Med Sci. 2023;28(1):27.
8. Song Y, Li W. Blood group B and decreased risk of coronary artery disease in hypertensive elderly. Invest Clin. 2022;63(4):388-399.

9. Chen Z, Yang SH, Xu H, Li JJ. ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis. Sci Rep. 2016;6(1):23250.
10. Cesena FHY, Da Luz PL. ABO blood group and precocity of coronary artery disease. Thromb Res. 2006;117(4):401-402.
11. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45(36):3415-3537.
12. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983;51(3):606.
13. Ho DE, Imai K, King G, Stuart EA. MatchIt: Nonparametric Preprocessing for Parametric Causal Inference. J Stat Softw. 2011;42(8):1-28.
14. 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.
15. 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.
16. Pai M U, Samanth J, Rao S, et al. Association of ABO blood groups with the severity of coronary artery disease in southern India population: A prospective cross-sectional study. Indian Heart J. 2023;75(4):285-287.
17. Chen Y, Chen C, Ke X, et al. 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.
18. Whincup PH, Cook DG, Phillips AN, Shaper AG. ABO blood group and ischaemic heart disease in British men. BMJ. 1990;300(6741):1679-1682.
19. 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(5):376-379.
20. 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.
21. Madithadu A, Rajendran A, Durgaprasad R, Jothibai S. Association of coronary artery diseases with ABO and lewis blood group phenotypes at a tertiary care teaching hospital in Southern India. J Clin Diag Res. 2018;12(7):EC17-21.
22. Omidi NRKM, Khorgami MR, Effatpanah M, et al. Association between ABO blood group and severity of coronary artery disease in unstable angina. ARYA Atheroscler. 2017;13(5):233-238.
23. Zhou B, Wu N, Zhu C, et al. ABO blood group is a risk factor for coronary artery disease in patients with poor blood pressure control. Clin Exp Hypertens. 2017;39(4):366-370.
24. Blais C, Germain M, Delage G, Grégoire Y. The association between blood group and the risk of vascular disease in Quebec blood donors. Blood Transfusion. 2016;14(5):455-459.
25. Nafakhi H, Al-Nafakh HA, Al-Mosawi AA. ABO blood group differences relationship with coronary atherosclerotic markers. Artery Res. 2016;14:36-40.
26. Yip SP. Sequence variation at the human ABO locus. Ann Hum Genet. 2002;66(1):1-27.
27. Kaya A, Tanboǧa IH, Kurt M, et al. Relation of ABO blood groups to coronary lesion complexity in patients with stable coronary artery disease. Anatol J Cardiol. 2014;14(1):55-60.
28. Yusuf PS, Hawken S, Ôunpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet. 2004;364(9438):937-952.
29. Matsushita K, van der Velde M, Astor BC, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010;375(9731):2073-2081.
30. Visseren F, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227-3337.