Heart, Lung and Circulation

Effect of Different Blood Groups on Long-Term Outcomes of Surgical Revascularisation

Published:January 21, 2022DOI:


      ABO blood groups are considered to be associated with cardiovascular disease. Nonetheless, the definite effect of ABO blood groups on the clinical outcome of coronary artery bypass graft surgery (CABG) is still undetermined. We evaluated whether ABO blood groups can predict long-term major adverse cardiocerebrovascular events (MACCE) in CABG patients.


      In this retrospective cohort study, we retrieved the clinical files of eligible patients treated with isolated CABG in our hospital between March 2007 and March 2016. We divided the patients into four ABO subgroups. The primary study endpoints were the occurrence of all-cause mortality and MACCE during long-term follow-ups. We used Cox regression survival analysis to define the association of ABO blood groups with the occurrence of MACCE.


      Of 17,892 patients who underwent isolated CABG, 17,713 (mean age, 61.19±9.47 years, 74.6% male) were successfully followed, and their data used in the final analysis. Our multivariable analysis demonstrated that patients with different blood groups had similar 5-year mortality and 5-year MACCE.


      Our findings suggest that in patients who underwent CABG, ABO blood groups were not associated with long-term MACCE.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Heart, Lung and Circulation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Amirzadegan A.
        • Salarifar M.
        • Sadeghian S.
        • Davoodi G.
        • Darabian C.
        • Goodarzynejad H.
        Correlation between ABO blood groups, major risk factors, and coronary artery disease.
        Int J Cardiol. 2006; 110: 256-258
        • Sari I.
        • Ozer O.
        • Davutoglu V.
        • Gorgulu S.
        • Eren M.
        • Aksoy M.
        ABO blood group distribution and major cardiovascular risk factors in patients with acute myocardial infarction.
        Blood Coagul Fibrinolysis. 2008; 19: 231-234
        • Capuzzo E.
        • Bonfanti C.
        • Frattini F.
        • Montorsi P.
        • Turdo R.
        • Previdi M.G.
        • et al.
        The relationship between ABO blood group and cardiovascular disease: results from the Cardiorisk program.
        Ann Transl Med. 2016; 4: 189
        • Franchini M.
        • Liumbruno G.M.
        ABO blood group: old dogma, new perspectives.
        Clin Chem Lab Med. 2013; 51: 1545-1553
        • González A.O.
        • Medina J.R.
        • Martin L.
        • Alvarez V.
        • Coto E.
        The O blood group protects against venous thromboembolism in individuals with the factor V Leiden but not the prothrombin (factor II G20210A) mutation.
        Blood Coagul Fibrinolysis. 1999; 10: 303-307
        • Meade T.W.
        • Cooper J.A.
        • Stirling Y.
        • Howarth D.J.
        • Ruddock V.
        • Miller G.J.
        Factor VIII, ABO blood group and the incidence of ischaemic heart disease.
        Br J Haematol. 1994; 88: 601-607
        • Souto J.C.
        • Almasy L.
        • Muniz-Diaz E.
        • Soria J.M.
        • Borrell M.
        • Bayen L.
        • et al.
        Functional effects of the ABO locus polymorphism on plasma levels of von Willebrand factor, factor VIII, and activated partial thromboplastin time.
        Arterioscler Thromb Vasc Biol. 2000; 20: 2024-2028
        • O'donnell J.
        • Laffan M.
        The relationship between ABO histo-blood group, factor VIII and von Willebrand factor.
        Transfus Med. 2001; 11: 343-351
        • Thompson S.G.
        • Kienast J.
        • Pyke S.D.
        • Haverkate F.
        • van de Loo J.C.
        Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group.
        N Engl J Med. 1995; 332: 635-641
        • Iturbe T.
        • Cornudella R.
        • de Miguel R.
        • Olave T.
        • Moreno J.A.
        • Callen L.
        • et al.
        Hypercoagulability state in hip and knee surgery: influence of ABO antigenic system and allogenic transfusion.
        Transfus Sci. 1999; 20: 17-20
        • Biancari F.
        • Satta J.
        • Pokela R.
        • Juvonen T.
        ABO blood group distribution and severity of coronary artery disease among patients undergoing coronary artery bypass surgery in Northern Finland.
        Thromb Res. 2002; 108: 195
        • Huang X.
        • Zou Y.
        • Li L.
        • Chen S.
        • Hou J.
        • Yu B.
        Relation of ABO blood groups to the plaque characteristic of coronary atherosclerosis.
        Biomed Res Int. 2017; 2017: 2674726
        • Zhang Y.
        • Li S.
        • Zhu C.G.
        • Guo Y.L.
        • Wu N.Q.
        • Xu R.X.
        • et al.
        Risk factors, coronary severity, outcome and ABO blood group: a large Chinese Han cohort study.
        Medicine (Baltimore). 2015; 94: e1708
        • Abbasi K.
        • Karimi A.
        • Abbasi S.H.
        • Ahmadi S.H.
        • Davoodi S.
        • Babamahmoodi A.
        • et al.
        Knowledge management in cardiac surgery: the second tehran heart center adult cardiac surgery database report.
        J Tehran Heart Cent. 2012; 7: 111-116
        • Karimi A.
        • Ahmadi S.
        • Davoudi S.
        • Marzban M.
        • Movahedi N.
        • Abbasi K.
        • et al.
        First database report on cardiothoracic surgery in Tehran Heart Center.
        Iran J Public Health. 2012; 37: 1-8
        • Welsby I.J.
        • Jones R.
        • Pylman J.
        • Mark J.B.
        • Brudney C.S.
        • Phillips-Bute B.
        • et al.
        ABO blood group and bleeding after coronary artery bypass graft surgery.
        Blood Coagul Fibrinolysis. 2007; 18: 781-785
        • Ravari A.
        • Sh S.M.
        • Hamedanizade F.
        • Tadrisi S.
        • Vahabi Y.
        Correlation between type of blood group and post operative bleeding in coronary artery bypass graft surgery.
        J Crit Care Nurs. 2009; 1: 1-4
        • Welsby I.J.
        • Phillips-Bute B.
        • Mathew J.P.
        • Newman M.F.
        • Becker R.
        • Rao S.
        • et al.
        ABO blood group influences transfusion and survival after cardiac surgery.
        J Thromb Thrombolysis. 2014; 38: 402-408
        • Green D.
        • Jarrett O.
        • Ruth K.J.
        • Folsom A.R.
        • Liu K.
        Relationship among Lewis phenotype, clotting factors, and other cardiovascular risk factors in young adults.
        J Lab Clin Med. 1995; 125: 334-339
        • Orstavik K.H.
        Genetics of plasma concentration of von Willebrand factor.
        Folia Haematol Int Mag Klin Morphol Blutforsch. 1990; 117: 527-531
        • Bakker E.J.
        • Valentijn T.M.
        • Hoeks S.E.
        • van de Luijtgaarden K.M.
        • Leebeek F.W.
        • Verhagen H.
        • et al.
        ABO blood type does not influence the risk of cardiovascular complications and mortality after vascular surgery.
        Eur J Vasc Endovasc Surg. 2013; 45: 256-260
        • Januszkiewicz L.
        • Szczerba E.
        • Paszkowska P.
        • Cacko A.
        • Grabowski M.
        • Sierdzinski J.
        • et al.
        Association of blood groups with prognosis in acute coronary syndrome.
        Pol Arch Med Wewn. 2013; 123: 460-466
        • Carpeggiani C.
        • Coceani M.
        • Landi P.
        • Michelassi C.
        • L'Abbate A.
        ABO blood group alleles: a risk factor for coronary artery disease. An angiographic study.
        Atherosclerosis. 2010; 211: 461-466