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Associated risk factors for silent cerebral infarcts in sickle cell anemia: Low baseline hemoglobin, sex, and relative high systolic blood pressure

Associated risk factors for silent cerebral infarcts in sickle cell anemia: Low baseline hemoglobin, sex, and relative high systolic blood pressure
Associated risk factors for silent cerebral infarcts in sickle cell anemia: Low baseline hemoglobin, sex, and relative high systolic blood pressure

The most common form of neurologic injury in sickle cell anemia (SCA) is silent cerebral infarction (SCI). In the Silent Cerebral Infarct Multi-Center Clinical Trial, we sought to identify risk factors associated with SCI. In this cross-sectional study, we evaluated the clinical history and baseline laboratory values and performed magnetic resonance imaging of the brain in participants with SCA (HbSS or HbS|5 thalassemia) between the ages of 5 and 15 years with no history of overt stroke or seizures. Neuroradiology and neurology committees adjudicated the presence of SCI. SCIs were diagnosed in 30.8% (251 of 814) participants who completed all evaluations and had valid data on all prespecified demographic and clinical covariates. The mean age of the participants was 9.1 years, with 413 males (50.7%). In a multivariable logistic regression analysis, lower baseline hemoglobin concentration (P< .001), higher baseline systolic blood pressure (P = .018), and male sex (P = .030) were statistically significantly associated with an increased risk of an SCI. Hemoglobin concentration and systolic blood pressure are risk factors for SCI in children with SCA and may be therapeutic targets for decreasing the risk of SCI. This study is registered at www.clinicaltrials.gov as #NCT00072761.

0006-4971
3684-3690
DeBaun, Michael R.
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Sarnaik, Sharada A.
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Rodeghier, Mark J.
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Minniti, Caterina P.
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Howard, Thomas H.
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Inusa, Baba
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Telfer, Paul T.
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King, Allison A.
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Rhodes, Melissa M.
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Kwiatkowski, Janet K.
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Noetzel, Michael J.
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Ichord, Rebecca N.
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Casella, James F.
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DeBaun, Michael R., Sarnaik, Sharada A., Rodeghier, Mark J., Minniti, Caterina P., Howard, Thomas H., Iyer, Rathi V., Inusa, Baba, Telfer, Paul T., Kirby-Allen, Melanie, Quinn, Charles T., Bernaudin, Françoise, Airewele, Gladstone, Woods, Gerald M., Panepinto, Julie Ann, Fuh, Beng, Kwiatkowski, Janet K., King, Allison A., Rhodes, Melissa M., Thompson, Alexis A., Heiny, Mark E., Redding-Lallinger, Rupa C., Kirkham, Fenella J., Sabio, Hernan, Gonzalez, Corina E., Saccente, Suzanne L., Kalinyak, Karen A., Strouse, John J., Fixler, Jason M., Gordon, Mae O., Phillip Miller, J., Noetzel, Michael J., Ichord, Rebecca N. and Casella, James F. (2012) Associated risk factors for silent cerebral infarcts in sickle cell anemia: Low baseline hemoglobin, sex, and relative high systolic blood pressure. Blood, 119 (16), 3684-3690. (doi:10.1182/blood-2011-05-349621).

Record type: Article

Abstract

The most common form of neurologic injury in sickle cell anemia (SCA) is silent cerebral infarction (SCI). In the Silent Cerebral Infarct Multi-Center Clinical Trial, we sought to identify risk factors associated with SCI. In this cross-sectional study, we evaluated the clinical history and baseline laboratory values and performed magnetic resonance imaging of the brain in participants with SCA (HbSS or HbS|5 thalassemia) between the ages of 5 and 15 years with no history of overt stroke or seizures. Neuroradiology and neurology committees adjudicated the presence of SCI. SCIs were diagnosed in 30.8% (251 of 814) participants who completed all evaluations and had valid data on all prespecified demographic and clinical covariates. The mean age of the participants was 9.1 years, with 413 males (50.7%). In a multivariable logistic regression analysis, lower baseline hemoglobin concentration (P< .001), higher baseline systolic blood pressure (P = .018), and male sex (P = .030) were statistically significantly associated with an increased risk of an SCI. Hemoglobin concentration and systolic blood pressure are risk factors for SCI in children with SCA and may be therapeutic targets for decreasing the risk of SCI. This study is registered at www.clinicaltrials.gov as #NCT00072761.

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More information

Accepted/In Press date: 23 September 2011
Published date: 19 April 2012

Identifiers

Local EPrints ID: 429229
URI: http://eprints.soton.ac.uk/id/eprint/429229
ISSN: 0006-4971
PURE UUID: b8b806cf-7512-4536-b963-3ef91957e7c9
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

Catalogue record

Date deposited: 22 Mar 2019 17:30
Last modified: 20 Jul 2022 01:39

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Contributors

Author: Michael R. DeBaun
Author: Sharada A. Sarnaik
Author: Mark J. Rodeghier
Author: Caterina P. Minniti
Author: Thomas H. Howard
Author: Rathi V. Iyer
Author: Baba Inusa
Author: Paul T. Telfer
Author: Melanie Kirby-Allen
Author: Charles T. Quinn
Author: Françoise Bernaudin
Author: Gladstone Airewele
Author: Gerald M. Woods
Author: Julie Ann Panepinto
Author: Beng Fuh
Author: Janet K. Kwiatkowski
Author: Allison A. King
Author: Melissa M. Rhodes
Author: Alexis A. Thompson
Author: Mark E. Heiny
Author: Rupa C. Redding-Lallinger
Author: Hernan Sabio
Author: Corina E. Gonzalez
Author: Suzanne L. Saccente
Author: Karen A. Kalinyak
Author: John J. Strouse
Author: Jason M. Fixler
Author: Mae O. Gordon
Author: J. Phillip Miller
Author: Michael J. Noetzel
Author: Rebecca N. Ichord
Author: James F. Casella

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