Sickle Cell Trait and Incident Ischemic Stroke in the Atherosclerosis Risk in Communities Study

Caughey, Melissa C.; Loehr, Laura R.; Key, Nigel S.; Derebail, Vimal K.; Gottesman, Rebecca F.; Kshirsagar, Abhijit V.; Grove, Megan L.; Heiss, Gerardo

doi:10.1161/strokeaha.114.006110

Cited by 51 publications

(53 citation statements)

References 32 publications

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“…It was observed that incident stroke is more frequents among SCT subjects compared to their homozygous HbA counterparts [27] tension and diabetes mellitus. The adjustment for these covariates might have reduced the effect of the observed association since hypertension is likely to be an intermediate factor in the progression to chronic kidney disease by SCT.…”

Section: Incident Strokementioning

confidence: 99%

Sickle Cell Trait: A Benign State?

Kotila

2016

Acta Haematol

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Background: Sickle cell trait (SCT) is the heterozygous form of sickle cell disease and expectedly should be a benign state with no complications ascribed to it. There are numerous reports challenging its being a benign condition, though this is controversial. Methods and Results: A review of the results of the accompanying investigations done on some of the patients show that beta thalassemia may be responsible for many of the ascribed symptoms and complications. These patients may therefore have sickle cell beta thalassemia, a compound heterozygous form of sickle cell disease. Conclusion: It is important to screen for beta thalassemia using red cell indices and quantitation of the different hemoglobin fractions before attributing any symptoms to SCT. DNA analysis, though useful in ascertaining the presence of the sickle cell gene, is not sufficient. There is the need to exclude the presence of mutations for beta thalassemia, which often is geographical region-specific.

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Section: Incident Strokementioning

confidence: 99%

Sickle Cell Trait: A Benign State?

Kotila

2016

Acta Haematol

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“…The difference was not statistically significant. In multivariable analysis that controlled for the traditional risk factors for stroke, sickle cell trait was associated with a 40% higher risk of stroke [20]. Despite this, further investigation of the incidence and pathophysiology of stroke in patients with sickle cell trait is warranted.…”

Section: Introductionmentioning

confidence: 99%

“…Also, there has not been any significant difference in the outcomes of stroke for sickle cell patients compared with normal haemoglobin [19]. In order to shed more light on this debatable association, a 24-year prospective epidemiological study was recently conducted observing an increased risk of ischaemic stroke in blacks with sickle cell trait [20]. In this study, the frequency of ischaemic stroke was slightly higher with sickle cell trait (13%) than in participants with normal adult haemoglobin (10%).…”

Section: Introductionmentioning

confidence: 99%

Sickle Cell Trait Appears to Increase the Risk of Hemorrhagic Stroke in African Adults with Dyslipidaemia: A Pilot Study

Paul¹

2017

Austin J Cerebrovasc Dis & Stroke

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“…Recent studies, however, suggest SCT may confer a higher risk for chronic kidney disease, thrombosis, stroke, and pregnancy-related complications in its carriers. [1][2][3][4][5][6] Importantly, there is growing concern SCT may be associated with sudden death during strenuous physical activity and exercise, leading to the National College Athletics Association to mandate carrier status testing among all student athletes in division I institutions in 2010, and later in all division II and III institutions. [7][8][9] Growing evidence suggests SCT carriers may exhibit abnormal physiologic responses to cardiopulmonary exercise testing when compared with controls without SCT.…”

Section: Introductionmentioning

confidence: 99%

Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA

Liem

Chan

et al. 2017

Blood

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Key Points• SCT status is not significantly associated with longitudinal changes in fitness among African Americans.• SCT status is not an independent risk factor for hypertension, diabetes, or metabolic syndrome among African Americans.The contribution of sickle cell trait (SCT) to racial disparities in cardiopulmonary fitness is not known, despite concerns that SCT is associated with exertion-related sudden death. We evaluated the association of SCT status with cross-sectional and longitudinal changes in fitness and risk for hypertension, diabetes, and metabolic syndrome over the course of 25 years among 1995 African Americans (56% women, 18-30 years old) in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Overall, the prevalence of SCT was 6.8% (136/1995) in CARDIA, and over the course of 25 years, 46% (738/1590), 18% (288/1631), and 40% (645/1,611) of all participants developed hypertension, diabetes, and metabolic syndrome, respectively. Compared with participants without SCT, participants with SCT had similar baseline measures of fitness in cross-section, including exercise duration (535 vs 540 seconds; P 5 .62), estimated metabolic equivalent of tasks (METs; 11.6 vs 11.7; P 5 .80), maximum heart rate (174 vs 175 beats/min; P 5 .41), and heart rate at 2 minutes recovery (44 vs 43 beats/min; P 5 .28). In our secondary analysis, there was neither an association of SCT status with longitudinal changes in fitness nor an association with development of hypertension, diabetes, or metabolic syndrome after adjustment for sex, baseline age, body mass index, fitness, and physical activity. SCT is not associated with reduced fitness in this longitudinal study of young African American adults, suggesting the increased risk for exertion-related sudden death in SCT carriers is unlikely related to fitness. SCT status also is not an independent risk factor for developing hypertension, diabetes, or metabolic syndrome. (Blood. 2017;129(6):723-728) IntroductionSickle cell trait (SCT) is caused by the inheritance of a single copy of the variant b globin gene, which results in production of abnormal sickle hemoglobin. The coinheritance of 2 copies of the abnormal gene results in sickle cell anemia (SCA), a clinically significant blood disorder seen primarily among individuals of African or Afro-Caribbean descent. Historically, SCT, which is observed in 8% of the African American population in the United States, has been considered a clinically benign condition. Recent studies, however, suggest SCT may confer a higher risk for chronic kidney disease, thrombosis, stroke, and pregnancy-related complications in its carriers.1-6 Importantly, there is growing concern SCT may be associated with sudden death during strenuous physical activity and exercise, leading to the National College Athletics Association to mandate carrier status testing among all student athletes in division I institutions in 2010, and later in all division II and III institutions. [7][8][9] Growing evidence suggests SCT carriers may exh...

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Sickle Cell Trait and Incident Ischemic Stroke in the Atherosclerosis Risk in Communities Study

Cited by 51 publications

References 32 publications

Sickle Cell Trait: A Benign State?

Sickle Cell Trait: A Benign State?

Sickle Cell Trait Appears to Increase the Risk of Hemorrhagic Stroke in African Adults with Dyslipidaemia: A Pilot Study

Association among sickle cell trait, fitness, and cardiovascular risk factors in CARDIA

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