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The relation between ABO blood types and clinical and platelet function parameters in patients who underwent percutaneous coronary intervention

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ABO blood groups have been associated with venous thromboembolism and arterial thrombosis. Although platelets play key roles in thrombogenesis, the relation between ABO groups and platelets is not well known and was investigated in this study.

Patients and methods

ABO blood type information was retrospectively obtained for 206 patients who underwent percutaneous coronary intervention (PCI) and received dual antiplatelet therapy with aspirin and clopidogrel. Platelet function was measured using VerifyNow system, light transmission aggregometry, thromboxane B2, urinary 11-dehydrothromboxane B2, and vasodilator-stimulated phosphoprotein phosphorylation assays. Samples were also tested following treatment with 10 and 30 ┬Ámol/l of aspirin or 30 and 100 ┬Ámol/l of P2Y12 inhibitor 2-methylthioadenosine 5′-monophosphate triethylammonium salt hydrate (2-MeSAMP). Forty-four clinical and 30 platelet function parameters were analyzed. Patients were categorized as aspirin or clopidogrel poor responder (PR) according to cutoff levels of each test.


Blood type A was significantly associated with myocardial infarction (MI) history [odds ratio (OR)=2.50, 95% confidence interval (CI)=1.37–4.58, P=0.003], higher baseline troponin T and creatine kinase-MB (CK-MB) index, post-PCI CK-MB index, and platelet reactivity index (PRI), and being PR against 2-MeSAMP (OR=5.75, 95% CI=1.51–21.90, P=0.010). Blood type O was associated with higher arachidonic acid-induced platelet aggregation and negatively associated with MI history (OR=0.47, 95% CI=0.26–0.84, P=0.010), PRI and being PR against clopidogrel (OR=0.54, 95% CI=0.30–0.99, P=0.043) and 2-MeSAMP (OR=0.16, 95% CI=0.03–0.76, P=0.021).


Blood type A was found as a risk factor for MI. Higher arachidonic acid-induced aggregation in group O and higher PRI in group A against aspirin and P2Y12 inhibitor treatment, respectively, may suggest alternative antiplatelet therapies for PRs with these blood types.
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Keywords: ABO blood types; aspirin; clopidogrel; platelet function; poor responder; thrombosis

Document Type: Research Article

Affiliations: 1: Robert J. Tomsich Pathology and Laboratory Medicine Institute 2: Quantitative Health Sciences, Cleveland Clinic 3: Heart and Vascular Center, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio 4: Brigham and Women’s Hospital Heart and Vascular Center, and Harvard Medical School, Boston, Massachusetts, USA

Publication date: January 1, 2019

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