Epidemiology
ABO blood group A or B sharpens Lp(a)'s link to MACE in chronic coronary syndrome, replicated across two cohorts totalling over 15,500 patients (MedComm (2020) 2025)
Original title: Lipoprotein(a), ABO Blood Types and Clinical Outcomes: Novel Findings and Clinical Implications in Patients With Chronic Coronary Syndrome
This study tested whether ABO blood group modifies the association between Lp(a) and major adverse cardiovascular events (MACE) in chronic coronary syndrome, using an exploratory cohort (n = 7,611; 560 MACEs over a mean 54.80-month follow-up) and a confirmatory cohort (n = 7,916), excluding patients with blood group AB. In both cohorts, the Lp(a)-prognosis relationship was more pronounced in patients with blood group A or B: those with group A or B plus medium Lp(a) had a significantly higher MACE risk than group O with low Lp(a) (HR 1.93, 95% CI 1.24-3.01), rising further with high Lp(a) (HR 2.06, 95% CI 1.32-3.24). This is the first demonstration that non-O blood group amplifies Lp(a)'s prognostic association in chronic coronary syndrome, suggesting ABO typing could help refine which patients benefit most from Lp(a)-targeted risk management, pending mechanistic and prospective confirmation.
Original abstract
This study aimed to investigate the effect of lipoprotein(a) (Lp(a)) on major adverse cardiovascular events (MACEs) among individuals with chronic coronary syndrome (CCS) according to ABO blood groups. Two independent cohorts of patients with CCS were included consecutively. Blood groups and Lp(a) levels were measured. Patients with the AB group were excluded due to the small sample size. In the exploratory cohort (n = 7611), 560 MACEs were recorded over a mean follow-up of 54.80 months. Stratification analysis revealed that the relationship of elevated Lp(a) levels with prognosis was more pronounced in patients with blood group A or B. Patients with blood group A or B plus medium Lp(a) (HR, 1.93, 95% CI: 1.24-3.01) or high Lp(a) (HR, 2.06, 95% CI: 1.32-3.24) concentrations had a significantly higher risk of MACEs compared to those with blood group O and low Lp(a) levels. Similar results were obtained in the confirmatory cohort (n = 7916). In conclusion, our data demonstrated for the first time a more prominent association between Lp(a) and adverse outcomes in CCS patients with non-O blood group compared to those with blood group O, suggesting that ABO blood group measurement may be clinically useful for decision-making in Lp(a) intervention.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 17 August 2026. Methods.