Key result
Nonmyeloablative stem cell transplant in sickle cell disease is linked to ~48 mg/dL higher total cholesterol.
Why the study?
Myocardial infarction and coronary atherosclerosis are reported to be scarce in patients with sickle cell anemia, but detailed characterization is limited.
Cohort (n=116)
No
Absolute Event Rate: 180% vs 132%
p-value: p=<0.0001
May warrant lipid monitoring after HCT in SCD; leaves open effects on cardiovascular outcomes.
A review of the electrocardiograms (ECG) of 108 patients with sickle cell anemia found only 3 with patterns consistent with myocardial infarction. Two of the 3 patients with ECG infarct patterns had postmortem examination confirmation of the infarction. These two patients had no significant coronary atherosclerosis nor did the other six autopsied patients in the present series. Literature reports of postmortem examinations on patients with sickle cell anemia confirm the scarcity of coronary atherosclerosis and myocardial infarction in these patients. Forty of the 108 ECGs showed signs of left ventricular hypertrophy and 20 others had nondiagnostic ST and T wave abnormalities. Nine showed first degree AV block and four right bundle branch block.
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Barrett et al. (1984) conducted a cohort in Sickle Cell Disease (n=116). Nonmyeloablative hematopoietic cell transplantation (HCT) vs. Baseline (pre-HCT) was evaluated on Total cholesterol level at 5 years post-HCT (p=<0.0001). Nonmyeloablative hematopoietic cell transplantation in patients with sickle cell disease resulted in significant increases in mean total cholesterol from 132 mg/dL at baseline to 180 mg/dL at 5 years post-transplant.
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