A Message to Health Care Providers: "A" Blood Group Is Associated with Higher Heart Disease Risk in Young Saudi Men

Given the limited number of studies evaluating the relationship of ABO blood groups and Premature coronary artery disease (PCAD) as well as the lack of relevant literature in Saudi Arabia, a study to assess the association of ABO blood groups and PCAD in Saudi population was crucial.

This is a retrospective comparative study, where controls are healthy individuals and cases are divided into: patients younger than 51 years (PCAD) with confirmed coronary artery disease and patients ≥ 51 years (CAD) with confirmed coronary artery disease, whose data are retrieved from 2015 to 2022. Severity of the disease is assessed by vessel score and Gensini score.

We have collected a total of 1167 samples; 466 individuals served as controls (39.9%), 346 were PCAD cases (29.6%), and 355 were CAD patients (30.4%). No significant overall difference was found in ABO distribution among healthy, PCAD, and CAD individuals, although blood group A is more common in PCAD and CAD patients than in healthy controls. Among males, there is a statistically significant difference in ABO distribution across healthy, PCAD, and CAD groups, with a higher frequency of blood group A and a lower frequency of O in patients compared to controls (A = 19.7%, 28.1%, 28.4%, B = 17.5%, 19.0%, 18.6%, O = 60.0%, 48.3%, 50.2%, AB = 2.8%, 4.6%, 2.8%, p = 0.041, respectively). Additionally, the difference in ABO is not statistically significant between the healthy females, PCAD female patients, and CAD female patients (A = 25.5%, 31.3%, 25.7%, B = 20.7%, 13.3%, 20.0%, O = 47.2%, 53.0%, 51.4%, AB = 6.6%, 2.4%, 2.9%, p = 0.541, respectively). The result reveals the severity of coronary vessel occlusion in PCAD group by using Gensini score as follows: A: 52.81 ± 31.30, B: 66.94 ± 45.57, O: 43.06 ± 32.95, AB: 49.00 ± 49.40 with p value = 0.131.

The present findings suggest that higher frequency of blood group "A" was found among male patients with PCAD and CAD compared to other blood groups. In addition, blood group "O" is less associated with male PCAD and CAD in Saudi population. Identification of ABO blood groups might assist in the genetic screening as well as guiding prophylaxis for premature CAD.