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Lipoprotein(a), ABO Blood Types and Clinical Outcomes: Novel Findings and Clinical Implications in Patients With

Hui-Hui Liu1,2, Chen-Xi Song3, Sha Li1

  • 1Cardiometabolic Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases National Clinical Research Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.

Medcomm
|December 1, 2025
PubMed

Insights

Lipoprotein(a) (Lp(a)) significantly increases cardiovascular event risk in chronic coronary syndrome patients with non-O blood types. This highlights the importance of ABO blood group in assessing Lp(a) related risks.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Clinical Research

Background:

  • Lipoprotein(a) (Lp(a)) is an established risk factor for cardiovascular disease.
  • Chronic coronary syndrome (CCS) patients have a high risk of major adverse cardiovascular events (MACEs).
  • The influence of ABO blood groups on Lp(a) related cardiovascular risk is not well understood.

Purpose of the Study:

  • To investigate the combined effect of lipoprotein(a) (Lp(a)) levels and ABO blood groups on major adverse cardiovascular events (MACEs) in patients with chronic coronary syndrome (CCS).
  • To determine if non-O blood groups modify the association between Lp(a) and cardiovascular outcomes.

Main Methods:

  • Analysis of two independent cohorts of CCS patients (total n=15527).
  • Measurement of blood groups and serum Lp(a) levels.
  • Stratified analysis of MACEs based on Lp(a) concentrations and ABO blood groups (excluding AB group).

Main Results:

  • Elevated Lp(a) levels were associated with a significantly higher risk of MACEs in patients with blood group A or B compared to blood group O.
  • Patients with blood group A or B and medium or high Lp(a) showed a 1.93-fold and 2.06-fold increased risk of MACEs, respectively.
  • Findings were consistent across both exploratory and confirmatory cohorts.

Conclusions:

  • ABO blood group influences the prognostic impact of Lp(a) in CCS patients.
  • Non-O blood groups (A and B) are associated with a more pronounced Lp(a)-related risk of MACEs.
  • ABO blood typing may aid in identifying CCS patients who could benefit from Lp(a)-targeted interventions.

Keywords:
blood groupchronic coronary syndromelipoprotein(a)outcome

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