# Add-Ons of Heart Disease from the Cardiosurgical Perspective: Gender, Blood Groups and Renal Function

## TL;DR

The study explores how heart disease patterns differ by gender and blood group, finding that men and women show distinct trends in coronary and valvular heart disease.

## Contribution

The study identifies gender-specific patterns in heart disease and their association with blood groups and renal function in cardiac surgery patients.

## Key findings

- Men were more likely to have CAD-only, while women more often had valve disease requiring surgery.
- Blood group O was less common in women, and valve disease was linked to reduced kidney function, especially in women.
- These gender-specific patterns suggest blood group and renal function should be considered in cardiac surgery planning.

## Abstract

Background/Objectives: This retrospective exploratory study aimed to characterize sex-specific patterns of coronary artery disease (CAD) and valvular heart disease (VHD) in a cardiac surgical cohort. In clinical routine, men appear to be more commonly affected by obstructive CAD, whereas women more frequently present valvular heart disease requiring surgical intervention. It remains unclear whether these sex-specific patterns are related to ABO blood groups and selected clinical parameters. Methods: Here, we retrospectively analyzed 983 patients admitted between 2020 and 2024 to a single cardiac centre with CAD and/or VHD requiring valve replacement. Patients were stratified by sex and disease entity (CAD only, CAD + VHD, isolated VHD). ABO and Rhesus factor distributions, cardiovascular risk factors, body mass index (BMI), and renal function (estimated glomerular filtration rate, eGFR) were assessed. Group comparisons were performed using Chi-square and Welch’s t-tests. Associations were evaluated using multivariable logistic and linear regression models adjusted for age, BMI, diabetes mellitus, hypertension, smoking, and eGFR. Results: Men were predominantly represented in the CAD-only group, whereas women more frequently underwent valve replacement, either isolated or combined with CAD (p < 0.001). When comparing the overall study cohort, blood group O was less prevalent in women than in men (p = 0.031), whereas blood group A was more frequent among female patients, although this difference did not reach statistical significance. Moreover, patients with valve disease demonstrated lower eGFR compared with those without valve involvement (men: −6.3 mL/min/1.73 m2, p = 0.0036; women: −10.4 mL/min/1.73 m2, p = 0.0019). This effect remained independently associated with reduced eGFR, with women slightly more affected. Conclusions: Gender- specific diseases should be included as secondary diagnoses when considering cardiac surgery. Nephrological complications in the postoperative period can be an important factor in assessing the benefits of surgery. Blood group O was more common in male Patients, suggesting that cardiovascular diseases also exhibit blood group dependence.