People with A blood group have higher incidence of coronary artery disease in South Indian population

The prospective cross-sectional study showed a higher incidence of CAD among people with blood group A. Among the patients who underwent elective coronary angiogram (CAG), blood group A showed a higher incidence of severe CAD, triple vessel disease, left ventricular dysfunction, and acute coronary syndrome (ACS).

Coronary artery disease is a multifactorial disease and is considered a significant concern of cardiovascular disease. CAD is reported to be one of the leading causes of death in industrialized to developing countries. The influence of cumulative pathologic effects from various CV risk factors plays a potential role in CAD development. In the process of disease progression, these cohorts present with heart failure (HF), Myocardial Infarction (MI), or cardiac arrhythmias.

Many patients with an MI do not possess any of the significant risk factors. In this context, the studies focusing on the association between ABO blood grouping and CAD have documented that the locus presence 9p21 plays an essential role in CAD progression. Therefore, based on the preliminary data, Umesh Pai M, Manipal Academy of Higher Education, Manipal, Karnataka, India, and colleagues sought to exploit further the relationship between the ABO blood groups and CAD and the severity of CAD in the South Indian population.

The study included 1500 patients undergoing elective CAG at a tertiary care hospital in Karnataka. Baseline demographic data and the presence of cardiac comorbidities were documented. Data was compiled from baseline echocardiography and angiographic studies.

1086 (72.4%) patients were diagnosed to have coronary artery disease; 68.53% were males.

The authors reported the following findings:

• There was a statistically significant association between the blood group and hypertension, where blood group AB had a higher prevalence of hypertension than other groups.
• The prevalence of acute coronary syndrome was higher among blood group A compared to B, AB and O groups.
• The incidence of CAD was significantly higher in blood group AA (81.26%) than in the other blood groups, with a minor occurrence in group B (66.06%)
• Triple Vessel disease (TVD) was observed to be the highest among blood group A (32.5%) compared to the other blood groups, whereas blood group O had the highest frequency of patients with normal coronaries (31.3%)
• Gensini's score illustrated that blood group A had a higher median value for the severity of CAD than blood groups B and AB.
• Among 414 Non-CAD groups, the O group was the commonest blood group found in 42.02% of patients, followed by the B group at 30.19%, the AB group at 7%, and the A group at 20.77%.

"We observed a higher CAD incidence along with a more severe form of atherosclerosis in patients with A blood groups compared to controls," the researchers wrote.

"In the future, population-based studies comprising a large cohort of data may highlight the significance and genetic aspect of the ABO blood group and their association with the disease pathology, occurrence, and prognosis of CAD," they concluded.

Reference:

Pai M, U., Samanth, J., Rao, S., V, R., A, M., P, G., Shah, K., Kumar, V., Jose, J., Jabeen, A., Lewis, J. H., G, J. T., Suresh, A., & Haque, N. (2023). Association of ABO blood groups with the severity of coronary artery disease in southern India population: A prospective cross-sectional study. Indian Heart Journal. https://doi.org/10.1016/j.ihj.2023.05.001