ABO Blood Group Influence on Cardiovascular and Hematologic Disorders
Summary
The ABO blood group system, defined by the presence of A and B antigens on red blood cells, exerts a measurable impact on both cardiovascular and haematologic health. Non-O blood types (A, B and AB) have consistently been linked to elevated levels of von Willebrand factor, a key mediator of platelet adhesion, and to higher concentrations of coagulation factors VIII and IX. These alterations contribute to a prothrombotic milieu, increasing the risk of arterial and venous thromboses, including coronary artery disease, stroke and venous thromboembolism. Conversely, blood group O is generally associated with lower plasma levels of these proteins, conferring a modest protective effect against atherosclerotic events but also an increased propensity for bleeding in certain settings. Beyond coagulation, variations in blood-group antigens influence plasma lipid profiles, endothelial function and inflammatory responses, further modulating susceptibility to myocardial injury, cerebrovascular events and complications during surgical or renal replacement therapies. This multifaceted influence underscores the importance of ABO group as a non-modifiable genetic factor in personalised risk assessment and preventive strategies for cardiovascular and haemostatic disorders on a global scale.
Research from Nature Portfolio
Recent evidence has highlighted the role of ABO blood type in perioperative cardiac risk. A large retrospective cohort of patients undergoing non-cardiac surgery demonstrated that individuals with blood group B face a significantly higher incidence of myocardial injury after non-cardiac surgery (MINS) compared with non-B patients. This association persisted after adjustment for conventional risk factors, suggesting an intrinsic link between B-antigen expression and perioperative myocardial vulnerability. Separately, a comprehensive systematic review and meta-analysis of coronary artery disease studies confirmed that blood group A is associated with an increased risk of coronary events, whereas group O confers a relative reduction in risk. These aggregated data underscore the consistency of ABO influences across diverse populations and clinical contexts, reinforcing the relevance of blood-group stratification in cardiovascular risk prediction and management.
ABO Blood Group Influence on Cardiovascular and Hematologic Disorders publication trend
The graph below shows the total number of articles in abo blood group influence on cardiovascular and hematologic disorders across all publications each year (not limited to Nature Index journals).
Technical terms
von Willebrand factor (VWF): A plasma glycoprotein crucial for platelet adhesion and primary haemostasis.
Myocardial injury after non-cardiac surgery (MINS): Cardiac muscle damage detected by elevated troponin levels following non-cardiac operations.
Large artery atherosclerosis (LAA): A subtype of ischaemic stroke caused by significant stenosis or occlusion of major cerebral arteries.
Galectin-3: A β-galactoside-binding lectin involved in inflammation, fibrosis and cell-matrix interactions.
Path analysis: A statistical method to dissect direct and indirect relationships among variables in observational studies.
References
- Galectin-3 and Blood Group: Binding Properties, Effects on Plasma Levels, and Consequences for Prognostic Performance. International Journal of Molecular Sciences (2023).
- Association between blood groups and myocardial injury after non-cardiac surgery: a retrospective cohort study. Scientific Reports (2024).
- Non-O blood types are associated with a greater risk of large artery atherosclerosis stroke and dysregulation of cholesterol metabolism: an observational study. Lipids in Health and Disease (2024).
- Non-A Blood Type Is a Risk Factor for Poor Cardio-Cerebrovascular Outcomes in Patients Undergoing Dialysis. Biomedicines (2023).
- ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis. Scientific Reports (2016).
- Relationship between ABO blood group and von Willebrand factor levels: from biology to clinical implications. Thrombosis Journal (2007).
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