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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.


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?° 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.

SUBMITTER: DeBaun MR 

PROVIDER: S-EPMC3335377 | biostudies-literature | 2012 Apr

REPOSITORIES: biostudies-literature

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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.

DeBaun Michael R MR   Sarnaik Sharada A SA   Rodeghier Mark J MJ   Minniti Caterina P CP   Howard Thomas H TH   Iyer Rathi V RV   Inusa Baba B   Telfer Paul T PT   Kirby-Allen Melanie M   Quinn Charles T CT   Bernaudin Françoise F   Airewele Gladstone G   Woods Gerald M GM   Panepinto Julie Ann JA   Fuh Beng B   Kwiatkowski Janet K JK   King Allison A AA   Rhodes Melissa M MM   Thompson Alexis A AA   Heiny Mark E ME   Redding-Lallinger Rupa C RC   Kirkham Fenella J FJ   Sabio Hernan H   Gonzalez Corina E CE   Saccente Suzanne L SL   Kalinyak Karen A KA   Strouse John J JJ   Fixler Jason M JM   Gordon Mae O MO   Miller J Phillip JP   Noetzel Michael J MJ   Ichord Rebecca N RN   Casella James F JF  

Blood 20111117 16


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 HbSβ° thalassemia) between the ages of 5 and 15 years with no history of overt stroke or seiz  ...[more]

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