Anjiografi Yapılan ve Normal Koroner Arterler Gözlenen Stabil Anjina Pektorisli Hastalarda Koroner Yavaş Akımın Prediktörü Olarak ABO Kan Grupları

Yıl 2024, Cilt: 8 Sayı: 3, 348 - 354, 30.12.2024

Uğur Köktürk , Talha Serin , Fatma Tuğçe Topuz , Berkay Işık , Ayşe Nur Eken , Abdülkadir Ataç , Nazende Altıntaş , Rabia Çağlardağ , Kübra Balık , Zeynep İsmihan Avşar , Esra Özgüler , İpek Naz Gündoğan

Öz

Amaç: Çalışmada stabil anjina pektoris tanısıyla koroner anjıografi yapılan ve normal koroner arter bulunan hastalarda koroner yavaş
akımla ABO kan grupları arasındaki ilişkinin araştırılması amaçlanmıştır.
Gereç ve Yöntemler: Çalışmaya stabil anjina pektoris tanısıyla koroner anjiografi yapılan ve normal koroner arter saptanan 203 hasta
retrospektif olarak alınmıştır. Hastalar yavaş akım ve normal akım gözlenen olarak iki gruba ayrılmıştır. ABO kan grupları ve koroner yavaş
akım arasındaki ilişki incelenmiştir.
Bulgular: Yavaş akım gözlenen gruptaki hastalar kontrol grubuna göre daha ileri yaştaydı (p=0,049). Yavaş akım gözlenen grupta kontrol
grubuna göre anlamlı olarak 0 kan grubu, 0 olmayan kan gruplarına göre daha düşük gözlenmesine rağmen, A kan grubu, A olmayan
kan grubuna göre anlamlı olarak daha yüksek gözlenmiştir (sırasıyla p=0,024 karşı p=0,038). Çok değişkenli analiz, stabil anjina pektoris
ile başvuran koroner anjiyografi yapılan ve koroner arterleri normal olan hastalarda A kan grubunun, koroner yavaş akışın bağımsız bir
belirleyicisi olarak pozitif ilişkili olduğunu belirlemesine rağmen 0 kan grubunun ters ilişkili olduğunu gösterdi. (sırasıyla, OR: 2,226; 95%
CI:1,067-4,646; p=0,033, OR=0,836; %95CI=0,451-0,957; p=0,042).
Sonuç: Bu çalışma stabil anjina pektoris tanısı alıp koroner anjiografi yapılan ve normal koroner arter saptanan hastalarda koroner yavaş
akım ile ABO kan grupları arasında ilişki olabileceğini göstermiştir. Ek olarak, A kan grubunun bu hastalarda koroner yavaş akımın bağımsız
öngördürücüsü olduğunu tespit etmiştir.

Anahtar Kelimeler

ABO kan grubu, stabil anjina pektoris, yavaş akım

Etik Beyan

Zonguldak Bülent Ecevit Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır (Tarih:20/03/2024, No:2024/06).

ABO Blood Groups as Predictors of Coronary Slow Flow in Patients with Stable Angina Pectoris Who Underwent Angiography and Observed Normal Coronary Arteries

Öz

Aim: In this study, we aimed to investigate the relationship between coronary slow flow and ABO blood groups in patients who presented
with stable angina pectoris and underwent coronary angiography, and had normal coronary arteries.
Material and Methods: 203 patients who were diagnosed with stable angina pectoris and underwent coronary angiography and were found
to have normal coronary arteries were included in the study retrospectively. Patients were divided into two groups: those with slow flow and
those without. The relationship between ABO blood groups and coronary slow flow was examined.
Results: Patients in the slow flow group were older than the control group (p=0.049). Although the 0 blood group was observed to be
significantly lower than the non-0 blood groups in the slow flow group compared to the normal flow group, the A blood group was significantly
higher than the non-A blood group (p=0.024 vs p=0.038, respectively). Multivariate analysis determined that blood type A was positively
associated as an independent predictor of coronary slow flow in patients who underwent coronary angiography presenting with stable angina
pectoris and had normal coronary arteries, whereas blood group O was inversely associated. (OR:2.226; 95%CI:1.067-4.646; p=0.033,
OR=0.836; %95CI=0.451-0.957; p=0.042, respectively).
Conclusion: This study showed that there is a relationship between coronary slow flow and ABO blood groups in patients who were
diagnosed with stable angina pectoris and underwent coronary angiography and normal coronary arteries were detected. Additionally, it
found that blood type A was an independent predictor of coronary slow flow in these patients

Anahtar Kelimeler

ABO blood group, stable angina pectoris, slow flow

Kaynakça

• 1. Hawkins BM, Stavrakis S, Rousan TA, Abu-Fadel M, Schechter E. Coronary slow flow–prevalence and clinical correlations. Circ J. 2012;76:(4):936–942.
• 2. Chalikias G, Tziakas D. Slow coronary flow: pathophysiology, clinical implications, and therapeutic management. Angıology. 2021;72:(9):808–818.
• 3. Camici PG, D’Amati G, Rimoldi O. Coronary microvascular dysfunction: mechanisms and functional assessment. Nat Rev Cardiol. 2015;12:(1):48–62.
• 4. Patel MR, Peterson ED, Dai D, Brennan JM, Redberg RF, Anderson HV, Brindis RG, Douglas PS. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:(10):886– 895.
• 5. Wang ZJ, Zhang LL, Elmariah S, Han HY, Zhou YJ. Prevalence and prognosis of nonobstructive coronary artery disease in patients undergoing coronary angiography or coronary computed tomography angiography: a meta- analysis. Mayo Clin Proc. 2017;92:(3):329–346.
• 6. Ouellette ML, Loffler AI, Beller GA, Workman VK, Holland E, Bourque JM. Clinical characteristics, sex differences, and outcomes in patients with normal or near-normal coronary arteries, non- obstructive or obstructive coronary artery disease. J Am Heart Assoc. 2018;7:e007965.
• 7. Brainin P, Frestad D, Prescott E. The prognostic value of coronary endothelial and microvascular dysfunction in subjects with normal or non-obstructive coronary artery disease: a systematic review and meta-analysis. Int J Cardiol. 2018;254:1–9.
• 8. Erikssen J, Thaulow E, Stormorken H, Brendemoen O, Hellem A. ABO blood groups and coronary heart disease (CHD). A study in subjects with severe and latent CHD. Thromb Haemost. 1980;43:137-140.
• 9. 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;211:461- 466.
• 10. Garrison RJ, Havlik RJ, Harris RB, Feinleib M, Kannel WB, Padgett SJ. ABO blood group and cardiovascular disease: the Framingham study, Atherosclerosis 1976;25: 311-318.
• 11. Whincup PH, Cook DG, Phillips AN, Shaper AG. ABO blood group and ischaemic heart disease in British men, Br Med J. 1990;300:1679-1682.
• 12. Kaya A, Tanboga IH, Kurt M, Işık T, Kaya Y, Günaydın ZY, Aksakal E. Relation of ABO blood groups to coronary lesion complexity in patients with stable coronary artery disease, Anadolu Kardiyol Derg. 2014;14:55-60.
• 13. Gong P, Luo SH, Li XL, Guo YL, Zhu CG, Xu RX, Li S, Dong Q, Liu G, Chen J, Zeng RX, Li JJ. Relation of ABO blood groups to the severity of coronary atherosclerosis: an Gensini score assessment. Atherosclerosis. 2014;237(2):748-753.
• 14. Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, McCabe CH, Raymond L, Fortin T, Poole WK, Braunwald E. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1996;93:(5):879–888.
• 15. Wang X, Nie SP. The coronary slow flow phenomenon: characteristics, mechanisms and implications. Cardiovasc Diagn Ther. 2011;1(1):37-43.
• 16. Wozakowska-Kapłon B, Niedziela J, Krzyzak P, Stec S. Clinical manifestations of slow coronary flow from acute coronary syndrome to serious arrhythmias. Cardiol J. 2009;16(5):462- 468.
• 17. Atak R, Turhan H, Sezgin AT, Yetkin O, Senen K, Ileri M, Sahin O, Karabal O, Yetkin E, Kutuk E, Demirkan D. Effects of slow coronary artery flow on QT interval duration and dispersion. Ann Noninvasive Electrocardiol. 2003;8(2):107-111.
• 18. Cin VG, Pekdemir H, Camsar A, Ciçek D, Akkus MN, Parmaksýz T, Katýrcýbaý T, Döven O. Diffuse intimal thickening of coronary arteries in slow coronary flow. Jpn Heart J. 2003;44(6):907-919.
• 19. Beltrame JF, Limaye SB, Wuttke RD, Horowitz JD. Coronary hemodynamic and metabolic studies of the coronary slow flow phenomenon. Am Heart J. 2003;146(1):84-90.
• 20. Wu O, Bayoumi N, Vickers MA, Clark P. ABO(H) blood groups and vascular disease: a systematic review and meta-analysis, J Thromb Haemost. 2008;6:62-69.
• 21. Anvari MS, Boroumand MA, Shoar S, Naderan M, Bina P. Ascending aorta aneurysm and blood group A among Iranian patients, Thromb Res. 2013;131:51-53.
• 22. Ohira T, Cushman M, Tsai MY, Zhang Y, Heckbert SR, Zakai NA, Rosamond WD, Folsom AR. ABO blood group, other risk factors and incidence of venous thromboembolism: the longitudinal investigation of thromboembolism etiology (LITE), J Thromb Haemost. 2007;5:1455-1461.
• 23. Nydegger UE, Wuillemin WA, Julmy F, Meyer BJ, Carrel TP. Association of ABO histo-blood group B allele with myocardial infarction, Eur J Immunogenet 2003;30:201-206.
• 24. von Beckerath N, Koch W, Mehilli J, Gorchakova O, Braun S, Schömig A, Kastrati A. ABO locus O1 allele and risk of myocardial infarction, Blood Coagul Fibrinolysis 2004;15:61-67.
• 25. 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;50:1815-1820.
• 26. He M, Wolpin B, Rexrode K, Wang CL, Chang CJ, Hsu LA. ABO blood group and risk of coronary heart disease in two prospective cohort studies. Arterioscler Thromb Vasc Biol. 2012;32:2314-2320.
• 27. Karabuva S, Carevic V, Radic M, Fabijanic D. The association of ABO blood groups with extent of coronary atherosclerosis in croatian patients suffering from chronic coronary artery disease. Biochem Med. 2013;23:351-359.
• 28. Deloukas P, Kanoni S, Willenborg C. Large-scale association analysis identifies new risk loci for coronary artery disease, Nat Genet. 2013;45:25-33.
• 29. Silbernagel G, Chapman MJ, Genser B, Kleber ME, Fauler G, Scharnagl H, Grammer TB, Boehm BO, Mäkelä KM, Kähönen M, Carmena R, Rietzschel ER, Bruckert E, Deanfield JE, Miettinen TA, Raitakari OT, Lehtimäki T, März W. High intestinal cholesterol absorption is associated with cardiovascular disease and risk alleles in ABCG8 and ABO: evidence from the LURIC and YFS cohorts and from a meta-analysis, J Am Coll Cardiol. 2013;62:291-299.
• 30. Eastlund T. The histo-blood group ABO system and tissue transplantation. Transfusion. 1998;38:975-988.
• 31. Jenkins PV, O’Donnell JS. ABO blood group determines plasma von Willebrand factor levels: a biologic function after all. Transfusion. 2006;46:1836-1844.
• 32. O’Donnell J, Laffan MA. The relationship between ABO histo- blood group, factor VIII and von Willebrand factor. Transfus Med. 2001;11:343-351.
• 33. Ray KK, Francis S, Crossman DC. Measurement of plasma von Willebrand factor in acute coronary syndromes and the influence of ABO blood group status, J Thromb Haemost. 2004;2:2053-2054.
• 34. Paterson AD, Lopes-VirellaMF, Waggott D, Boright AP, Hosseini SM, Carter RE, Shen E, Mirea L, Bharaj B, Sun L, Bull SB; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Genome- wide association identifies the ABO blood group as a major locus associated with serum levels of soluble E-selectin, Arterioscler Thromb Vasc Biol. 2009;29:1958-1967.
• 35. Barbalic M, Dupuis J, Dehghan A, Bis JC, Hoogeveen RC, Schnabel RB, Nambi V, Bretler M, Smith NL, Peters A, Lu C, Tracy RP, Aleksic N, Heeriga J, Keaney JF Jr, Rice K, Lip GY, Vasan RS, Glazer NL, Larson MG, Uitterlinden AG, Yamamoto J, Durda P, Haritunians T, Psaty BM, Boerwinkle E, Hofman A, Koenig W, Jenny NS, Witteman JC, Ballantyne C, Benjamin EJ. Large-scale genomic studies reveal central role of ABO in sP-selectin and sICAM-1 levels. Hum Mol Genet. 2010;19:1863-1872.