Abstract
ABSTRACT Background: Coronary Artery Disease (CAD) is a complex interaction of genetic and multifactorial environmental factors. This study was conducted to evaluate the association of blood groups with the severity of coronary artery lesions in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Methods: This descriptive cross-sectional study was conducted at a tertiary cardiac care center in Karachi, Pakistan. Consecutive adult patients of either gender diagnosed with ST-segment elevation myocardial infarction (STEMI) undergone primary PCI during the study period of November 2020 to February 2021 were included. Based on blood grouping patients were stratified into two groups, non-O and O. comparative analysis of clinical and angiographic findings was performed and Chi-square test was used with p-value ≤ 0.05 was considered statistically significant. Results: A total of 398 patients were included in this study out of which 296(74.4%) were males (mean age: 57.15±10.95 years) and 102(25.6%) females. Type O blood group distribution was 107(26.9%) and non-O blood groups were 291(73.1%). The non-O blood group included A=110(27.6%), AB=43(10.8%), and B=138(34.7%). Significant results in type O and non-O group were seen among single vessel diseases (41.1%, 29.6%) (p=0.029) and circumflex artery as culprit (16.8%,9.6%) (p=0.046), whereas in post-procedure complication no significant results were found (p=0.554) with in-hospital mortality rate (p=0.642). Conclusion: Blood group type O was found to be associated with single-vessel coronary artery diseases. However, no association of blood groups was observed with lesion complexity, post-procedure complications and mortality. Keywords: Ischemic Heart Diseases; Coronary Artery Diseases; Myocardial Infarction; Blood Group.
Highlights
The Asian population, especially South Asians, remains at an increased risk of ischemic heart diseases (IHD), contrary to the western world, an increase in the prevalence of coronary artery diseases (CAD) is expected for this region in the few decades[1]
Inclusion criteria for the study were consecutive adult patients of either gender diagnosed with ST-segment elevation myocardial infarction (STEMI) undergone primary percutaneous coronary intervention (PCI) during the study period of four months from November 2020 to February 2021
Data for this study were collected on a structured proforma consisting of demographic characteristics, co-morbid conditions (diabetes, hypertension, positive family history for coronary artery diseases (CAD), obesity, and smoking), presentation details (Killip class, time of presentation, and vital signs at presentation), angiographic findings (coronary dominance, number of diseased vessels, localization of diseases, stenosis (%), lesion length, lesion complexity (Syntax score II), pre and post-procedure thrombolysis in myocardial infarction (TIMI) flow grade, and procedural details), and post-procedure complications and in-hospital outcomes (requirement of mechanical ventilation, arrhythmias/heart block, cardiogenic shock, acute kidney injury (AKI), slow/no-reflow, bleeding, sepsis, acute stent thrombosis, cardiac arrest, pulmonary edema, or in-hospital mortality)
Summary
The Asian population, especially South Asians, remains at an increased risk of ischemic heart diseases (IHD), contrary to the western world, an increase in the prevalence of coronary artery diseases (CAD) is expected for this region in the few decades[1]. Increasing trends in low and middle-income countries (LMCs) pose new challenges for global public health, collectively. Mass media campaigns to promote a healthy lifestyle along with preventive measures such as increased taxation on tobacco products, restrictions on smoking in public places, health warnings on the packaging of cigarettes, and free blood pressure screening events in major cities have proved effective in decreasing disease burden in high-income countries[7]. The increasing trend of CAD in low- and middle-income countries can be partly associated with the increasing urbanization and adoption of westernized lifestyles without proper access to such programs[8]. This study was conducted to evaluate the association of blood groups with the severity of coronary artery lesions in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PCI)
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