ABO Blood Groups, Lipids, and Coronary CT Imaging in A Japanese Single-Center Cohort

TL;DR

This study found that ABO blood type does not significantly affect coronary artery disease risk in Japanese adults when considering standard risk factors.

Contribution

The study provides new evidence on ABO blood groups and coronary disease in a Japanese population using CT imaging.

Findings

ABO blood type was not independently linked to coronary calcium or stenosis after adjusting for standard risk factors.

Type O blood was associated with lower HDL-C and higher diastolic pressure, but not with coronary disease outcomes.

Age, sex, hypertension, and diabetes were the main predictors of coronary disease in this cohort.

Abstract

Background and Objectives: Non-O ABO blood groups have been linked to higher coronary risk, plausibly via hemostatic and lipid pathways. However, evidence in Japanese populations and imaging-defined disease is limited. We examined whether ABO status relates to serum lipids and coronary CT imaging findings in Japanese adults. Materials and Methods: We reviewed adults who underwent coronary CT angiography (CCTA) at our institution. After prespecified exclusions, 865 patients comprised the imaging cohort. For lipid analyses, we excluded patients receiving lipid-lowering therapy at the time of blood sampling, leaving 636 patients (lipid subset). ABO blood group was obtained from the medical record as recorded at registration (patient-reported) and was not re-confirmed by laboratory testing for this study. Outcomes were any coronary artery calcium (Agatston score > 0) and ≥50% luminal stenosis on CCTA. Results: In the lipid subset (n = 636), coronary calcium was present in 44–54% of patients across the four ABO groups and did not differ across groups (p = 0.33). Among assessable scans in the imaging cohort, ≥50% stenosis did not differ across the four ABO groups. In multivariable models (n = 636), older age, male sex, hypertension, and diabetes were independently associated with both outcomes (CAC presence and ≥50% stenosis) (all p < 0.05). For ≥50% stenosis, higher High-Density Lipoprotein-cholesterol (HDL-C) was additionally associated with lower odds (p < 0.05). ABO status (O vs. non-O) was not independently associated with either outcome. Conclusions: In Japanese adults undergoing CCTA, type O blood was tied to lower HDL-C and higher diastolic pressure—features that track with cardiometabolic risk—yet ABO type did not independently relate to coronary calcium or CT-defined stenosis once standard risk factors were considered. These data suggest that, in this setting, ABO adds little beyond conventional risk profiling.