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Meta-Analysis of Non-O Blood Group as an Independent Risk Factor for Coronary Artery Disease
Hisato Takagi1, Takuya Umemoto1,
1Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
Insights
Non-O blood groups are linked to a higher risk of coronary artery disease (CAD) and myocardial infarction. This meta-analysis confirms non-O blood type as an independent risk factor for these cardiovascular conditions.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Epidemiology
Background:
- Blood group determination is a routine clinical practice.
- Previous studies have suggested a link between non-O blood groups and cardiovascular disease.
- The independent risk factor status of non-O blood groups for coronary artery disease (CAD) requires further clarification.
Purpose of the Study:
- To ascertain if non-O blood group is an independent risk factor for coronary artery disease (CAD).
- To quantify the association between non-O blood group and the incidence of CAD and myocardial infarction.
Main Methods:
- A meta-analysis was conducted on contemporary studies identified through MEDLINE and EMBASE searches (January 2001-March 2015).
- Eligible studies reported adjusted odds ratios (ORs) or hazard ratios (HRs) for CAD in non-O versus O blood groups using multivariable regression models.
- Study-specific estimates were pooled using a random-effects model with inverse variance-weighted averages.
Main Results:
- Twelve relative risk estimates from 10 eligible studies, involving 174,945 participants, were included in the meta-analysis.
- Non-O blood group was associated with a statistically significant 14% increase in CAD incidence (OR/HR 1.14; 95% CI: 1.04-1.25; p=0.006).
- Analysis of 8 studies on myocardial infarction also showed a significant increased risk for non-O blood groups (OR/HR 1.16; 95% CI: 1.02-1.31; p=0.02).
Conclusions:
- Non-O blood group is identified as an independent risk factor for coronary artery disease (CAD).
- The findings indicate a statistically significant association between non-O blood groups and an increased risk of myocardial infarction.
- This meta-analysis provides robust evidence supporting the role of blood type in cardiovascular risk stratification.
Abstract:
To determine whether non-O blood group is an independent risk factor for coronary artery disease (CAD), we performed a meta-analysis of contemporary studies reporting adjusted relative risk estimates using multivariable logistic regression and multivariable Cox proportional hazards regression. MEDLINE and EMBASE were searched from January 2001 to March 2015 using Web-based search engines (PubMed and OVID). Search terms included blood group/type and coronary (artery/heart) disease, ischemic/ischaemic heart disease, acute coronary syndrome, myocardial infarction, or angina. Eligible were case-control, cross-sectional, or cohort studies reporting adjusted odds ratios (ORs) and hazard ratios (HRs) for CAD in subjects with non-O versus O blood group using multivariable logistic regression/multivariable Cox proportional hazards regression. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic ORs/HRs in the random-effects model. Of 117 potentially relevant articles screened initially, 12 relative risk estimates in 10 eligible studies were identified and included. Pooled analysis of all the 12 ORs/HRs demonstrated that non-O blood group was associated with a statistically significant 14% increase in CAD incidence relative to O blood group (OR/HR 1.14, 95% confidence interval 1.04 to 1.25, p = 0.006). There was no evidence of significant publication bias. Combining 8 studies reporting data regarding (acute) myocardial infarction also generated a statistically significant result unfavoring non-O blood group (OR/HR 1.16, 95% confidence interval 1.02 to 1.31, p = 0.02). In conclusion, we found that based on a meta-analysis of 10 studies enrolling a total of 174,945 participants, non-O blood group appears to be an independent risk factor for CAD and myocardial infarction.
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