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. 2014 Apr;12(4):564-70.
doi: 10.1111/jth.12507.

ABO blood type and stroke risk: the REasons for Geographic And Racial Differences in Stroke Study

N A Zakai  1 , S E Judd, K Alexander, L A McClure, B M Kissela, G Howard, M Cushman
Affiliations

ABO blood type and stroke risk: the REasons for Geographic And Racial Differences in Stroke Study

N A Zakai et al. J Thromb Haemost. 2014 Apr.

Abstract

Background: ABO blood type is an inherited trait associated with coagulation factor levels and vascular outcomes.

Objectives: To assess the association of blood type with stroke and whether blood type contributes to racial disparities in stroke in the United States.

Patients and methods: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study recruited 30 239 participants between 2003 and 2007. Using a case-cohort design, blood type was genotyped in 646 participants with stroke and a 1104-participant cohort random sample. Cox models that adjusted for Framingham stroke risk factors were used to assess the association of blood type with stroke.

Results: During 5.8 years of follow-up, blood types A or B vs. type O were not associated with stroke. Blood type AB vs. O was associated with an increased risk of stroke (adjusted hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.01-3.30). The association of blood type AB vs. O was greater in those without diabetes (adjusted HR 3.33, 95% CI 1.61-6.88) than those with diabetes (adjusted HR 0.49, 95% CI 0.17-1.44) (P interaction = 0.02). Factor VIII levels accounted for 60% (95% CI 11%-98%) of the association of AB blood type and stroke risk.

Conclusion: Blood type AB is associated with an increased risk of stroke that is not attenuated by conventional stroke risk factors, and factor VIII levels were associated with 60% of the association. While blood type AB is rare in the US population, it is a significant stroke risk factor and may play an important role in stroke risk in these individuals.

Keywords: ABO blood-group system; continental population groups; factor VIII; risk factors; stroke.

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Figures

Figure 1
Figure 1
Mediation of Increased Hazard Ratio of Black vs. White Race for Stroke by ABO Blood Type* *Solid black lines represent hazard ratios (solid grey lines represent 95% CI) without blood type in the model and dashed black lines represent hazard ratios (dashed grey lines represent 95 % CI) with blood type in the model at the ages listed on the horizontal axis. Adjusted for covariates in Risk Factor Model: Age, sex, race, region, age*race, systolic blood pressure, taking antihypertensive medications, diabetes, current smoking, cardiovascular disease, atrial fibrillation, and left ventricular hypertrophy. Blood type did not significantly mediate any of the association of black race with stroke at any age group (all p >0.05).
See this image and copyright information in PMC

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