ABO Blood Groups and Thrombosis: A Causal association, But is There Value in screening?

Abstract

ABO(H) antigens are expressed on red cells and on von Willebrand factor. An association between groups other than O and thrombosis exists: an effect that is predominantly mediated by von Willebrand factor. Overall, the risk of venous thrombosis associated with non-O has been estimated at 1.75-fold, with a higher risk (∼2.4-fold) in those with the least O(H) antigen (a combined group of A¹A¹/A¹B/BB). Preliminary evidence also suggests that blood group may influence the venous thromboembolism risk associated with factor V Leiden. Overall, ABO(H) has a more modest effect on arterial disease, with a consistent effect observed in peripheral vascular disease and no influence evident with angina. A modest effect on myocardial infarction and stroke has been reported in some but not all studies. The potential mechanisms whereby blood group influences thrombosis, the limitations of current evidence and the current and future role of blood groups in identifying those at risk of arterial and venous disease is discussed.

Keywords:

• ABO blood group
• myocardial infarction
• venous thrombosis
• von Willebrand factor

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.