Relation Of ABO Blood Group To Coronary Artery Disease

Part one Relation of ABO blood group to coronary artery diseaseObjective:we aimed to find a statistic link among ABO blood group and coronary artery disease.Methods:A total of 898 consecutive patients undergoing coronary angiography were enrolled, and divided into CAD group and control group according to their angiographic findings. According to their ABO blood group they were divided into O blood group and non-0 blood group, as well as A blood group and non-A blood group. Their baseline characteristics, and ABO blood group were collected. The link of ABO blood group and CAD was investigated.Results:Subjects of A type had higher concentration of total cholesterol and LDL-C compared with that of non-A type (4.43±1.12 mmol/1 vs 4.18±1.09 mmol/l,2.79±0.99 mmo/1 vs 2.59±1.01 mmol/l, P<0.01). After adjustment for traditional cardiovascular risk factors, blood group A remained significantly associated with CAD (OR= 1.884, 95% CI,1.280-2.774, p<0.01; OR=1.03,95% CI 1.018-1.033, p<0.01, respectively). Conclusion:In our research the data indicated that there was an association between ABO blood group and CAD status, and A blood group is a dependent risk factor of CAD.Part two Relation of ABO blood group to the severity of coronary atherosclerosis:an Gensini score assessmentObjective:Although the relationship between ABO blood groups and coronary atherosclerosis has a long history, few data is available in a large cohort study using an accurate assessment method and on consensus exists regarding its magnitude. We aimed to investigate the relation of ABO blood groups and the severity of coronary atherosclerosis assessed by Gensini score (GS) in Chinese patients undergoing coronary angiography.Methods:A total of 2919 consecutive patients undergoing coronary angiography were enrolled, and their baseline characteristics and ABO blood group were collected. The GS was calculated as 1st tertile (0-10),2nd tertile (11-36),3rd tertile (>36) according angiographic results. The association of ABO blood group with GS was investigated.Results:The frequency of blood group A was significantly higher in the upper GS tertiles (24.4% vs 28.2% vs 29.5%, p=0.032). Multivariable linear regression analysis revealed that blood group A was independently associated with GS (?=0.043, p=0.017). After adjustment for traditional cardiovascular risk factors such as age, gender, hypertension, smoking, diabetes mellitus, and lipid profiles, A blood group remained significantly associated with mid-high GS (OR=1.44,95% CI 1.16-1.80, p=0.001), and O blood group was protective factor (OR=0.77,95% CI=0.65-0.92, p=0.004). Conclusion:In this large Chinese cohort study the data indicate that there is an association between ABO blood group and the severity of coronary atherosclerosis, suggesting that blood group A is an independent risk factor for serious coronary atherosclerosis.Part three Total cholesterol Mediates the effect of ABO blood group on coronary heart diseaseObjective:we aimed to find a statistic link among ABO blood group, lipid profiles and CAD (coronary artery disease) and to estimate the effect size of connection using mediation analysis model.Methods:A total of 898 consecutive patients undergoing coronary angiography were enrolled, and divided into CAD group and control group according to their angiographic findings. According to their ABO blood group they were divided into O blood group and non-0 blood group, as well as A blood group and non-A blood group. Their baseline characteristics, and ABO blood group were collected. The link of ABO blood group, CAD and lipid profile was investigated.Results:Subjects of A type had higher concentration of total cholesterol and LDL-C compared with that of non-A type (4.43±1.12 mmol/1 vs 4.18±1.09 mmol/1,2.79±0.99 mmo/1 vs 2.59±1.01 mmol/l, P<0.01). CAD group had higher levels of TC and LDL-C and had lower concentration HDL-C and APOA1 (4.36±1.05 mmol/l vs 4.13±1.16 mmol/1; 2.61±0.87mmol/l vs 2.47±0.94 mmol/1; 40.75±11.00 mmol/1 vs44.46±13.00 mmol/1; 1.38±0.29 mmol/1 vs 1.45±0.33mmol/l; P<0.01, all). After adjustment for traditional cardiovascular risk factors, blood group A and TC remained significantly associated with CAD (OR=1.884,95% CI,1.280-2.774, p<0.01; OR=1.03,95% CI 1.018-1.033, p<0.01, respectively). Specially, mediation analysis indicated that 10.5% of the effect of A blood group on CAD was mediated by TC levels (p<0.01).Conclusion:In our research the data indicated that there was an association between ABO blood group, TC levels and CAD status. Around 10.5% of the effect of A blood group on CAD was mediated by TC levels.Part four High-sensitivity C-reactive protein Mediates the effect of ABO blood group on coronary heart diseaseObjective:Both ABO blood group and inflammation biomakers have been associated with coronary artery disease (CAD) and myocardial infarction (MI). In this study we aimed to test whether there was a relation of usual inflammation biomakers levels to ABO blood group. Further we aimed to find a statistic link among ABO blood group, inflammation biomakers and CAD/MI and to estimate the effect size of connection using mediation analysis in a large china population.Methods:A total of 3806 consecutive patients undergoing coronary angiography were enrolled, and their baseline characteristics, angiographic findings and ABO blood group were collected. The link of ABO blood group, CAD/MI and three usual inflammation biomakers, including high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR) and White blood cell (WBC) count, was investigated.Results:Subjects of non-0 type had higher concentration of hs-CRP compared with that of O type (p=0.001). CAD and MI had higher levels of hs-CRP, WBC, and NLR (P<0.05, all). After adjustment for traditional cardiovascular risk factors, non-0 blood group remained significantly associated with CAD and MI(OR=1.49,95% CI,1.20-1.84, p<0.001; OR=1.24,95% CI 1.04-1.47, p=0.017, respectively). Specially, mediation analysis indicated that 5.1% of the effect of non-0 blood group on CAD was mediated by hs-CRP levels (p=0.039) and that 9.7% of the effect of non-0 blood group on MI was mediated by hs-CRP levels (p=0.023).Conclusion:In our research the data indicated that there was an association between ABO blood group, hs-CRP and CAD/MI. Around 5.1% of the effect of non-0 blood group on CAD and 9.7% of the effect of non-0 blood group on MI was mediated by hs-CRP levels.