title: Risk of venous thromboembolism and myocardial infarction associated with factor V Leiden and prothrombin mutations and blood type.
abstract: BACKGROUND
  ABO blood type locus has been reported to be an important genetic determinant of venous and arterial thrombosis in genome-wide association studies. We tested the hypothesis that ABO blood type alone and in combination with mutations in factor V Leiden R506Q and prothrombin G20210A is associated with the risk of venous thromboembolism and myocardial infarction in the general population.
  
  
  METHODS
  We used data from 2 Danish studies that followed members of the general public from 1977 through 2010. We obtained the genotype of 66 001 white participants for ABO blood type, factor V Leiden R506Q and prothrombin G20210A. We calculated hazard ratios (HRs) and population attributable risk. Our main outcome measures were venous thromboembolism and myocardial infarction.
  
  
  RESULTS
  The multivariable adjusted HR for venous thromboembolism was 1.4 (95% confidence interval [CI] 1.3-1.5) for non-O blood type (v. O blood type). For the factor V Leiden R506Q mutation, the adjusted HR was 2.2 (95% CI 2.0-2.5) for heterozygous participants and 7.0 (95%CI 4.8-10) for homozygous participants (v. participants without the mutation). For prothrombin G20210A, the adjusted HR was 1.5 (95%CI 1.2-1.9) for heterozygous participants and 11 (95% CI 2.8-44) for homozygous participants (v. participants without the mutation). When we combined ABO blood type and factor V Leiden R506Q or prothrombin G20210A genotype, there was a stepwise increase in the risk of venous thromboembolism (trend, p<0.001). The population attributable risk of venous thromboembolism was 20% for ABO blood type, 10% for factor V Leiden R506Q and 1% for prothrombin G20210A. Multivariable adjusted HRs for myocardial infarction by genotypes did not differ from 1.0.
  
  
  CONCLUSIONS
  ABO blood type had an additive effect on the risk of venous thromboembolism when combined with factor V Leiden R506Q and prothrombin G20210A mutations; blood type was the most important risk factor for venous thromboembolism in the general population.
authors: Department of Clinical Biochemistry, Herlev Hospital, and the Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Birgitte F
authors: BF
authors: Sode
authors: Kristine H
authors: KH
authors: Allin
authors: Morten
authors: M
authors: Dahl
authors: Finn
authors: F
authors: Gyntelberg
authors: Børge G
authors: BG
authors: Nordestgaard
mesh_terms: D000017:ABO Blood-Group System / Q000235:genetics*; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005165:Factor V / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology*; D005820:Genetic Testing; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009154:Mutation; D009203:Myocardial Infarction / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology; D011110:Polymorphism, Genetic; D016016:Proportional Hazards Models; D011516:Prothrombin / Q000235:genetics*; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000235:genetics* / Q000503:physiopathology
chemical_list: D000017:ABO Blood-Group System; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin
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