title: ABO Blood Group and Risk of Thromboembolic and Arterial Disease: A Study of 1.5 Million Blood Donors.
abstract: BACKGROUND
  ABO blood groups have been shown to be associated with increased risks of venous thromboembolic and arterial disease. However, the reported magnitude of this association is inconsistent and is based on evidence from small-scale studies.
  
  
  RESULTS
  We used the SCANDAT2 (Scandinavian Donations and Transfusions) database of blood donors linked with other nationwide health data registers to investigate the association between ABO blood groups and the incidence of first and recurrent venous thromboembolic and arterial events. Blood donors in Denmark and Sweden between 1987 and 2012 were followed up for diagnosis of thromboembolism and arterial events. Poisson regression models were used to estimate incidence rate ratios as measures of relative risk. A total of 9170 venous and 24 653 arterial events occurred in 1 112 072 individuals during 13.6 million person-years of follow-up. Compared with blood group O, non-O blood groups were associated with higher incidence of both venous and arterial thromboembolic events. The highest rate ratios were observed for pregnancy-related venous thromboembolism (incidence rate ratio, 2.22; 95% confidence interval, 1.77-2.79), deep vein thrombosis (incidence rate ratio, 1.92; 95% confidence interval, 1.80-2.05), and pulmonary embolism (incidence rate ratio, 1.80; 95% confidence interval, 1.71-1.88).
  
  
  CONCLUSIONS
  In this healthy population of blood donors, non-O blood groups explain >30% of venous thromboembolic events. Although ABO blood groups may potentially be used with available prediction systems for identifying at-risk individuals, its clinical utility requires further comparison with other risk markers.
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.). vasan.kandaswamy@ki.se.
authors.forename: Senthil K
authors.initials: SK
authors.lastname: Vasan
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Klaus
authors.initials: K
authors.lastname: Rostgaard
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Ammar
authors.initials: A
authors.lastname: Majeed
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Henrik
authors.initials: H
authors.lastname: Ullum
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Kjell-Einar
authors.initials: KE
authors.lastname: Titlestad
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Ole B V
authors.initials: OB
authors.lastname: Pedersen
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Christian
authors.initials: C
authors.lastname: Erikstrup
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Kaspar Rene
authors.initials: KR
authors.lastname: Nielsen
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Mads
authors.initials: M
authors.lastname: Melbye
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Olof
authors.initials: O
authors.lastname: Nyrén
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjalgrim
authors.affiliation: From Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (S.K.V., A.M., O.N., G.E.); Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark (K.R., M.M., H.H.); Department of Clinical Immunology, Blood Bank, Rigshospitalet, University Hospital of Copenhagen, Denmark (H.U.); Department of Clinical Immunology, Odense University Hospital, Denmark (K.-E.T.); Department of Clinical Immunology, Næstved Hospital, Denmark (O.B.V.P.); Department of Clinical Immunology, Aarhus University Hospital, Denmark (C.E.); Department of Clinical Immunology, Aalborg University Hospital, Denmark (K.R.N.); and Hematology Centre, Karolinska University Hospital, Stockholm, Sweden (A.M., G.E.).
authors.forename: Gustaf
authors.initials: G
authors.lastname: Edgren
mesh_terms: D000017:ABO Blood-Group System / Q000032:analysis* / Q000235:genetics; D000328:Adult; D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000235:genetics; D001782:Blood Donors / Q000706:statistics & numerical data*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000235:genetics; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000235:genetics; D012008:Recurrence; D012044:Regression Analysis; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D013923:Thromboembolism / Q000453:epidemiology* / Q000235:genetics; D019851:Thrombophilia / Q000235:genetics; D020246:Venous Thrombosis / Q000453:epidemiology / Q000235:genetics; D055815:Young Adult
chemical_list: D000017:ABO Blood-Group System
keywords: ABO blood-group system; cardiovascular diseases; cerebrovascular disorders; stroke; thromboembolism; thrombosis