ABO Blood Group and Coronary Atherosclerosis in Thais at Ramathibodi Hospital

Abstract

Coronary artery disease (CAD) is one of major cause of death in the world including Thailand. The ABO blood group is one of genetic risk factors for CAD.
Objective: To study the relation between ABO blood group and coronary atherosclerosis  in Thais in order to preventing and reducing the death rate.
Methods: A total of 217 postmortem forensic cases with age of > 20 years from the Division of Forensic Medicine, Department of Pathology, Ramathibodi Hospital were studied for the relation of ABO blood group and coronary atherosclerosis. Clotted or ethylenediaminetetraacetic acid (EDTA) bloods were used for ABO grouping by standard hemagglutination test. The disease was diagnosed by gross and microscopic examinations. The severity of the disease revealed by occlusion of either 1, 2 or 3 main branches of coronary artery and the degree of occlusion. The risk of ABO blood group in coronary atherosclerosis was expressed as Odds ratio (OR). The OR value of >1, p value of <0.05 and 95% confidence interval were considered to be statistically significant.
Results: Coronary atherosclerosis was diagnosed in 101 out of 217 cases (46.5%). The disease found in 50.9% males (86 out of 169) and 31.2% females (15 out of 48). Males had the disease more than females with OR of 2.280, p = 0.0118. Blood group A and O appeared to be risk for coronary atherosclerosis in Thais in both males and females. It was noticed that blood group A had more disease than blood group O (OR = 1.327 vs 1.094) among males whereas blood group O had more disease than blood group A (OR = 1.750 vs 1.199) among females. There were 62.4% sudden death and 37.6% non-sudden death in this study. Blood group A and O were also increased in sudden death with coronary atherosclerosis with ORs of 1.215 and 1.151, respectively (p > 0.05). It was observed that the degree of coronary artery occlusion >75% (severe) was increased in blood group A (57.9%, OR = 1.592) and blood group AB (50.0%, OR = 1.067). In addition, occlusion of 3 main coronary arteries was increased in blood group B (43.8%, OR = 1.369, p > 0.05) and blood group AB (75.0%, OR = 5.455, p = 0.0356). Furthermore, myocardial infarction frequently occurred in blood group A and blood group O with ORs of 1.270 and 1.390, respectively.
Conclusion:  Blood group A and O probably be involved in coronary atherosclerosis and myocardial infarction in Thais. Blood group A was frequently observed in male while blood group O was frequently observed in female with the disease. To give health education about the risk of ABO blood group that susceptible to coronary atherosclerosis may reduce the death rate of the disease.

Keywords: ABO blood group, coronary atherosclerosis, coronary artery disease, CAD