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Add-Ons of Heart Disease from the Cardiosurgical Perspective: Gender, Blood Groups and Renal Function
Madeline Günther1,2, Dimitrij Zilakov2, Ardawan J Rastan1,2
1Heart Surgery, University Hospital Marburg and Giessen, 35043 Marburg, Germany.
Insights
Men with coronary artery disease (CAD) and women with valvular heart disease (VHD) show distinct patterns, with blood group O more common in men. These findings suggest cardiovascular diseases have blood group dependence.
Area of Science:
- Cardiovascular Medicine
- Cardiac Surgery
- Nephrology
Background:
- Men are typically diagnosed with obstructive coronary artery disease (CAD), while women more often present with valvular heart disease (VHD) requiring surgical intervention.
- The influence of ABO blood groups and clinical parameters on these sex-specific patterns in cardiac surgical patients remains unclear.
- Understanding these differences is crucial for personalized treatment strategies in cardiac surgery.
Purpose of the Study:
- To investigate sex-specific patterns of CAD and VHD in a cardiac surgical cohort.
- To explore the association between these patterns, ABO blood groups, and clinical parameters like renal function.
- To identify potential sex differences in cardiovascular disease presentation and risk factors.
Main Methods:
- Retrospective analysis of 983 cardiac surgery patients with CAD and/or VHD between 2020-2024.
- Stratification by sex and disease entity (CAD only, CAD + VHD, isolated VHD).
- Assessment of ABO blood groups, cardiovascular risk factors, BMI, and estimated glomerular filtration rate (eGFR); statistical analysis using Chi-square, Welch's t-tests, and multivariable regression.
Main Results:
- Men were more prevalent in the CAD-only group, while women more frequently underwent valve replacement (p < 0.001).
- Blood group O was less prevalent in women than men (p = 0.031), with blood group A more frequent in women.
- Patients with valve disease had lower eGFR (men: -6.3 mL/min/1.73 m², women: -10.4 mL/min/1.73 m²), with women more affected, indicating an independent association with reduced renal function.
Conclusions:
- Sex-specific diagnoses should be considered secondary diagnoses in cardiac surgery planning.
- Postoperative nephrological complications are significant factors in assessing surgical benefits.
- The higher prevalence of blood group O in male patients suggests a potential blood group dependence in cardiovascular diseases.
Background/Objectives:
This retrospective exploratory study aimed to characterize sex-specific patterns of coronary artery disease (CAD) and valvular heart disease (VHD) in a cardiac surgical cohort. In clinical routine, men appear to be more commonly affected by obstructive CAD, whereas women more frequently present valvular heart disease requiring surgical intervention. It remains unclear whether these sex-specific patterns are related to ABO blood groups and selected clinical parameters.
Methods:
Here, we retrospectively analyzed 983 patients admitted between 2020 and 2024 to a single cardiac centre with CAD and/or VHD requiring valve replacement. Patients were stratified by sex and disease entity (CAD only, CAD + VHD, isolated VHD). ABO and Rhesus factor distributions, cardiovascular risk factors, body mass index (BMI), and renal function (estimated glomerular filtration rate, eGFR) were assessed. Group comparisons were performed using Chi-square and Welch's t-tests. Associations were evaluated using multivariable logistic and linear regression models adjusted for age, BMI, diabetes mellitus, hypertension, smoking, and eGFR.
Results:
Men were predominantly represented in the CAD-only group, whereas women more frequently underwent valve replacement, either isolated or combined with CAD (p < 0.001). When comparing the overall study cohort, blood group O was less prevalent in women than in men (p = 0.031), whereas blood group A was more frequent among female patients, although this difference did not reach statistical significance. Moreover, patients with valve disease demonstrated lower eGFR compared with those without valve involvement (men: -6.3 mL/min/1.73 m2, p = 0.0036; women: -10.4 mL/min/1.73 m2, p = 0.0019). This effect remained independently associated with reduced eGFR, with women slightly more affected.
Conclusions:
Gender- specific diseases should be included as secondary diagnoses when considering cardiac surgery. Nephrological complications in the postoperative period can be an important factor in assessing the benefits of surgery. Blood group O was more common in male Patients, suggesting that cardiovascular diseases also exhibit blood group dependence.
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