Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
ABO blood group and cerebrovascular complications after carotid angiography and stenting: a natural thrombotic marker?
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Evsen Ali, Altunova Mehmet
Аннотация
BACKGROUND: Carotid angioplasty and stenting (CAS) has increasingly been used as an alternative to carotid endarterectomy (CEA) in the treatment of carotid artery disease. However, neurological complications following carotid angiography or CAS remain a clinical concern. This study aimed to evaluate whether naturally occurring ABO blood group antigens and hematological parameters are associated with cerebrovascular complications after diagnostic or therapeutic carotid angiography.
METHODS: In this single-center retrospective study, patients were classified as blood group O or non-O (A, B, or AB). Cerebrovascular complications were defined as in-hospital amaurosis fugax, transient ischemic attack (TIA), or stroke occurring after carotid angiography or carotid artery stenting (CAS).
RESULTS: A total of 316 patients who underwent carotid angiography were included; 106 (33.5%) had blood group O and 210 (66.5%) had non-O blood groups. Cerebrovascular events were significantly more frequent in patients with non-O blood groups. Stroke occurred in 13.8% of patients with non-O blood groups compared with 1.9% in those with blood group O (p < 0.001), while TIA was also more common in the non-O group (11.0% vs. 3.8%, p = 0.033). When stratified by procedure type, this association was predominantly observed in patients undergoing CAS, whereas cerebrovascular event rates were low and comparable between groups in patients undergoing diagnostic angiography alone. In univariable analysis, diabetes mellitus was associated with stroke (OR = 2.392, p = 0.024), while blood group O was associated with lower odds of stroke (OR = 0.120, p = 0.004). In multivariable analysis, blood group O (OR = 0.127, p = 0.007) and contrast volume (OR per 10 mL increase: 1.218, p < 0.001) remained independently associated with stroke, whereas diabetes mellitus was no longer statistically significant.
CONCLUSION: Non-O blood groups were associated with a higher risk of stroke and TIA following carotid angiography, particularly in patients undergoing CAS, whereas blood group O was associated with a lower risk of stroke. These findings should be interpreted with caution due to the observational design and potential residual confounding.
METHODS: In this single-center retrospective study, patients were classified as blood group O or non-O (A, B, or AB). Cerebrovascular complications were defined as in-hospital amaurosis fugax, transient ischemic attack (TIA), or stroke occurring after carotid angiography or carotid artery stenting (CAS).
RESULTS: A total of 316 patients who underwent carotid angiography were included; 106 (33.5%) had blood group O and 210 (66.5%) had non-O blood groups. Cerebrovascular events were significantly more frequent in patients with non-O blood groups. Stroke occurred in 13.8% of patients with non-O blood groups compared with 1.9% in those with blood group O (p < 0.001), while TIA was also more common in the non-O group (11.0% vs. 3.8%, p = 0.033). When stratified by procedure type, this association was predominantly observed in patients undergoing CAS, whereas cerebrovascular event rates were low and comparable between groups in patients undergoing diagnostic angiography alone. In univariable analysis, diabetes mellitus was associated with stroke (OR = 2.392, p = 0.024), while blood group O was associated with lower odds of stroke (OR = 0.120, p = 0.004). In multivariable analysis, blood group O (OR = 0.127, p = 0.007) and contrast volume (OR per 10 mL increase: 1.218, p < 0.001) remained independently associated with stroke, whereas diabetes mellitus was no longer statistically significant.
CONCLUSION: Non-O blood groups were associated with a higher risk of stroke and TIA following carotid angiography, particularly in patients undergoing CAS, whereas blood group O was associated with a lower risk of stroke. These findings should be interpreted with caution due to the observational design and potential residual confounding.