ABO blood types: influence on infarct size, procedural characteristics and prognosis.
BACKGROUND
Patients with non-O blood groups have higher plasma von Willebrand factor (vWF) levels than those with type O. vWF mediates platelet adhesion, aggregation and thrombosis. These considerations likely explain the prior observations that non-O patients have higher rates of arterial and venous thromboembolic events. However, the effect of blood group status on size of MI, procedural findings and outcomes after PCI for MI have not been reported.


METHODS
We analyzed 1198 patients who underwent percutaneous coronary intervention for acute myocardial infarction between 10/03 and 8/06, and who had ABO blood group status and clinical follow-up.


CONCLUSIONS
Patients with O blood type were slightly older (62 +/- 13 vs. 60 +/- 13 years; p = 0.017) had a higher prevalence of hypercholesterolemia (67% vs. 58%; p = 0.002), and had a higher burden of atherosclerosis with more vascular disease (17% vs. 13%; p = 0.017) and higher prevalence of previous PCI (22% vs. 17%; p = 0.025). Non-O blood group patients had larger infarcts as measured by median peak troponin (33 vs. 24; p = 0.037), total CK (721 vs. 532; p = 0.012) and CK-MB (101 vs. 68; p = 0.010). At PCI, non-O patients had increased visible thrombus and reduced TIMI flow pre-procedure. However, there were no differences in procedural success, in-hospital blood transfusion or occurrence of MACE at 1 year follow-up. Our data demonstrate that non-O compared to O blood groups patients have higher thrombus burden despite less extensive atherosclerosis. Nevertheless, outcomes at 1 year were similar.
Ketch
Terry R
TR
Cardiology Section, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1045, USA.
Turner
Samuel J
SJ
Sacrinty
Matthew T
MT
Lingle
Kevin C
KC
Applegate
Robert J
RJ
Kutcher
Michael A
MA
Sane
David C
DC
D000017:ABO Blood-Group System; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D050197:Atherosclerosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D009336:Necrosis / Q000473:pathology; D015995:Prevalence; D011379:Prognosis; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014841:von Willebrand Factor / Q000378:metabolism
D000017:ABO Blood-Group System; D014841:von Willebrand Factor