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

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

Research output: Contribution to journalArticle

114 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)3684-3690
Number of pages7
JournalBlood
Volume119
Issue number16
DOIs
StatePublished - Apr 19 2012
Externally publishedYes

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Cerebral Infarction
Blood pressure
Sickle Cell Anemia
Hemoglobins
Blood Pressure
Hypertension
Neurology
Magnetic resonance
Regression analysis
Nervous System Trauma
Logistics
Brain
Thalassemia
Imaging techniques
Seizures
Cross-Sectional Studies
Logistic Models
Stroke
Regression Analysis
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Associated risk factors for silent cerebral infarcts in sickle cell anemia : Low baseline hemoglobin, sex, and relative high systolic blood pressure. / 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.; Casella, James F.

In: Blood, Vol. 119, No. 16, 19.04.2012, p. 3684-3690.

Research output: Contribution to journalArticle

DeBaun, MR, Sarnaik, SA, Rodeghier, MJ, Minniti, CP, Howard, TH, Iyer, RV, Inusa, B, Telfer, PT, Kirby-Allen, M, Quinn, CT, Bernaudin, F, Airewele, G, Woods, GM, Panepinto, JA, Fuh, B, Kwiatkowski, JK, King, AA, Rhodes, MM, Thompson, AA, Heiny, ME, Redding-Lallinger, RC, Kirkham, FJ, Sabio, H, Gonzalez, CE, Saccente, SL, Kalinyak, KA, Strouse, JJ, Fixler, JM, Gordon, MO, Phillip Miller, J, Noetzel, MJ, Ichord, RN & Casella, JF 2012, 'Associated risk factors for silent cerebral infarcts in sickle cell anemia: Low baseline hemoglobin, sex, and relative high systolic blood pressure', Blood, vol. 119, no. 16, pp. 3684-3690. https://doi.org/10.1182/blood-2011-05-349621
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. ; Casella, James F. / Associated risk factors for silent cerebral infarcts in sickle cell anemia : Low baseline hemoglobin, sex, and relative high systolic blood pressure. In: Blood. 2012 ; Vol. 119, No. 16. pp. 3684-3690.
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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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T1 - Associated risk factors for silent cerebral infarcts in sickle cell anemia

T2 - Low baseline hemoglobin, sex, and relative high systolic blood pressure

AU - DeBaun, Michael R.

AU - Sarnaik, Sharada A.

AU - Rodeghier, Mark J.

AU - Minniti, Caterina P.

AU - Howard, Thomas H.

AU - Iyer, Rathi V.

AU - Inusa, Baba

AU - Telfer, Paul T.

AU - Kirby-Allen, Melanie

AU - Quinn, Charles T.

AU - Bernaudin, Françoise

AU - Airewele, Gladstone

AU - Woods, Gerald M.

AU - Panepinto, Julie Ann

AU - Fuh, Beng

AU - Kwiatkowski, Janet K.

AU - King, Allison A.

AU - Rhodes, Melissa M.

AU - Thompson, Alexis A.

AU - Heiny, Mark E.

AU - Redding-Lallinger, Rupa C.

AU - Kirkham, Fenella J.

AU - Sabio, Hernan

AU - Gonzalez, Corina E.

AU - Saccente, Suzanne L.

AU - Kalinyak, Karen A.

AU - Strouse, John J.

AU - Fixler, Jason M.

AU - Gordon, Mae O.

AU - Phillip Miller, J.

AU - Noetzel, Michael J.

AU - Ichord, Rebecca N.

AU - Casella, James F.

PY - 2012/4/19

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N2 - 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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