Prospective study of ABO blood type and the risk of pulmonary embolism in two large cohort studies

Brian M. Wolpin; Christopher Kabrhel; Raphaëlle Varraso; Peter Kraft; Eric B. Rimm; Samuel Z. Goldhaber; Carlos A. Camargo Jr; Charles S. Fuchs

doi:10.1160/TH10-05-0312

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2010; 104(05): 962-971
DOI: 10.1160/TH10-05-0312

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Prospective study of ABO blood type and the risk of pulmonary embolism in two large cohort studies

Brian M. Wolpin

¹Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

²Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusets, USA

,

Christopher Kabrhel

³Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

,

Raphaëlle Varraso

⁴INSERM, U780, Epidemiology and Biostatistics, Villejuif, France

⁵Univ. Paris-Sud, Villejuif, France

,

Peter Kraft

⁶Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

,

Eric B. Rimm

⁶Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

⁷Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA

⁸Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA

,

Samuel Z. Goldhaber

⁹Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

,

Carlos A. Camargo Jr

³Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA

⁶Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

⁸Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA

,

Charles S. Fuchs

¹Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

²Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusets, USA

⁸Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA

› Author Affiliations

Abstract

Summary

Prior studies have suggested an association of ABO blood type and the risk of venous thromboembolism; however, most studies were retrospective and lacked important covariates or validated endpoints. Moreover, risk estimates varied widely across studies. Therefore, we prospectively examined the association of blood type and the risk of incident pulmonary embolism (PE) in two large cohort studies, the Nurses’ Health Study and Health Professionals Follow-up Study. During 1,010,378 person-years of follow-up among 77,025 women and 30,105 men, 499 participants developed PE. Compared to those with O-blood type, participants with non-O blood type had multivariable-adjusted hazard ratios (HR) of 1.86 (95% CI, 1.35–2.57) for idiopathic PE, 1.29 (95% CI, 1.03–1.62) for non-idiopathic PE, and 1.46 (95% CI, 1.22–1.76) for any PE. Hazard ratios were similar for participants with blood types A, B, and AB. Age-adjusted absolute rates of idiopathic PE over 10 years of follow-up differed by blood type: 0.11% for O, 0.20% for A, 0.19% for AB, and 0.21% for B. For idiopathic PE, the population attributable fraction was 33% for inheritance of non-O blood type. Among past and current smokers, participants with non-O vs. O-blood type had a HR for idiopathic PE of 2.56 (95% CI, 1.61–4.08). Among never smokers, the HR for idiopathic PE was 1.30 (95% CI, 0.82–2.05; Pinteraction=0.04). In two large, prospective cohorts, ABO blood type was significantly associated with the risk of idiopathic and non-idiopathic PE, with even greater risk for idiopathic PE among current and past smokers with non-O blood type.

Keywords

Pulmonary embolism - inherited coagulation disorders - epidemiological studies

Full Text

References

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