ABO blood type and risk of porcine bioprosthetic aortic valve degeneration : SWEDEHEART observational cohort study

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Persson, MichaelKarolinska Institutet,Karolinska Institute,Karolinska University Hospital (author)

ABO blood type and risk of porcine bioprosthetic aortic valve degeneration : SWEDEHEART observational cohort study

Article/chapterEnglish2019

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2019-05-05
BMJ,2019

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LIBRIS-ID:oai:lup.lub.lu.se:b2e6623c-4eef-4f26-b9a7-496bf91d7014
https://lup.lub.lu.se/record/b2e6623c-4eef-4f26-b9a7-496bf91d7014URI
https://doi.org/10.1136/bmjopen-2019-029109DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:141132699URI

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Language:English
Summary in:English

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Objective Blood type A antigen on porcine aortic bioprostheses might initiate an immune reaction leading to an increased frequency of structural valve deterioration in patients with blood type B or O. The aim was to analyse the association between ABO blood type and porcine bioprosthetic aortic valve degeneration. Design Observational nationwide cohort study. Setting Swedish population-based study. Participants Adult patients (n=3417) who underwent surgical aortic valve replacement and received porcine bioprosthetic aortic valves between 1995 and 2012 from the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies register. The study database was enriched with information from other national registers. Exposure The patients were categorised into type A/AB and type B/O blood groups. Primary and secondary outcome measures Primary outcome measure was aortic valve reoperation, and secondary outcomes were heart failure and all-cause mortality. We report risk estimates that account for the competing risk of death. Results In total, 3417 patients were identified: 1724 (50.5%) with blood type A/AB and 1693 (49.5%) with blood type B/O. Both groups had similar baseline characteristics. The cumulative incidence of aortic valve reoperation was 3.4% (95% CI 2.5% to 4.4%) and 3.6% (95% CI 2.6% to 4.6%) in the type B/O and the A/AB group, respectively, at 15 years of follow-up (absolute risk difference: -0.2% (95% CI -1.5% to 1.2%)). There was no significantly increased risk for aortic valve reoperation in patients with blood type B/O compared with type A/AB (HR 0.95, 95% CI 0.62 to 1.45). There was no significant difference in absolute or relative risk of heart failure or death between the groups. Conclusions We found no significant association between patient blood type and clinical manifestations of structural valve deterioration following porcine aortic valve replacement. Our findings suggest that it is safe to use porcine bioprosthetic valves without consideration of ABO blood type in the recipient.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
adult cardiology
cardiac epidemiology
cardiac surgery
epidemiology
valvular heart disease

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Edgren, GustafKarolinska Institutet,Karolinska Institute,Stockholm South General Hospital (author)
Dalén, MagnusKarolinska Institutet,Karolinska Institute,Karolinska University Hospital (author)
Glaser, NatalieKarolinska Institutet,Karolinska Institute,Stockholm South General Hospital (author)
Olsson, Martin L.Lund University,Lunds universitet,Transfusionsmedicin,Forskargrupper vid Lunds universitet,Transfusion Medicine,Lund University Research Groups,Region Skåne(Swepub:lu)labm-mol (author)
Franco-Cereceda, AndersKarolinska Institutet,Karolinska Institute,Karolinska University Hospital (author)
Holzmann, Martin J.Karolinska Institutet,Karolinska Institute,Karolinska University Hospital (author)
Sartipy, UlrikKarolinska Institutet,Karolinska Institute,Karolinska University Hospital (author)
Karolinska InstituteKarolinska University Hospital (creator_code:org_t)

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In:BMJ Open: BMJ9:52044-6055

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By the author/editor: Persson, Michael; Edgren, Gustaf; Dalén, Magnus; Glaser, Natalie; Olsson, Martin L ...; Franco-Cereceda, ...; show more...; Holzmann, Martin ...; Sartipy, Ulrik; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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