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Published on: February 26, 2013
The association between thromboembolic complications and blood group in patients with atrial fibrillation
Jodi M Blustin1, Robert D McBane1, Matylda Mazur1
1Division of Cardiovascular Diseases, Gonda Vascular Center, Mayo Clinic, Rochester, MN.
Insights
Blood type O may reduce peripheral embolization risk in nonvalvular atrial fibrillation (AF) patients. However, blood type did not impact cerebral thromboembolic events or hemorrhage risk in AF patients.
Area of Science:
- Cardiology
- Hematology
- Genetics
Background:
- Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of thromboembolic complications.
- Blood type has been implicated in various cardiovascular conditions, but its role in AF-related complications requires further investigation.
Purpose of the Study:
- To investigate the association between ABO blood group and the risk of thromboembolic and hemorrhagic complications in patients with atrial fibrillation.
- To determine if specific blood types confer differential risk for stroke, embolism, or bleeding in AF patients.
Main Methods:
- Retrospective analysis of electronic medical records from January 1, 2004, to December 31, 2010, at Mayo Clinic.
- Inclusion criteria: patients diagnosed with AF with available blood group data.
- Outcomes assessed: stroke, transient ischemic attack, left atrial appendage thrombus, cerebral or peripheral embolism, and hemorrhagic stroke, adjusted for clinical risk factors (e.g., CHA2DS2-VASc score).
Main Results:
- Among 14,462 AF patients with blood group data, 12,363 had nonvalvular AF (NVAF).
- In NVAF patients, blood type O was associated with a significantly lower rate of peripheral embolization compared to other blood types (2.0% vs. 3.0%, OR 0.66, P<.001).
- No significant differences in cerebral thromboembolic event rates or hemorrhagic stroke rates were observed across blood groups in either NVAF or valvular AF patients.
Conclusions:
- Blood group O may offer a protective effect against peripheral cardioembolic complications in nonvalvular atrial fibrillation.
- This potential protective association might be partly attributed to lower circulating von Willebrand factor levels in individuals with blood type O.
- Blood type does not appear to influence the risk of cerebral thromboembolic events in patients with atrial fibrillation.
Objective:
To determine whether blood type affects the risk of thromboembolic complications in patients with atrial fibrillation (AF).
Patients And Methods:
The Mayo Clinic electronic medical record was searched (between January 1, 2004, and December 31, 2010) to identify all patients with AF with blood group assessment. Records were analyzed for stroke, transient ischemic attack, left atrium appendage thrombus, cerebral or peripheral embolism, and hemorrhagic stroke. All events were adjusted for Congestive heart failure, Hypertension, Age >75 Years, Diabetes mellitus, and Stroke/transient ischemic attack score.
Results:
Of the 47,816 patients with AF, 14,462 had blood group type available (40% women; mean age, 73±12 years). These included 12,363 patients with nonvalvular atrial fibrillation (NVAF) (40% women; mean age, 73±12 years) and 2099 patients with valvular AF (41% women, mean age, 73±12 years). Within patients with NVAF, the rate of peripheral embolization was significantly lower in those with blood type O (2.0%) than in those with other blood types (3.0%; odds ratio, 0.66; 95% CI, 0.52-0.84; P<.001). Neither cerebral thromboembolic (8.1% for "O" vs 8.2% for "non-O" blood group for NVAF and 7.29% vs 7.76% for valvular AF) nor cerebral hemorrhage (2.0% each group) events rates differed by blood group.
Conclusion:
Blood group O may be protective against peripheral cardioembolic complications of NVAF, which may relate, in part, to reduced circulating von Willebrand factor levels. Cerebral thromboembolic event rates did not differ by blood group.
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