ATLANTA (Dec. 8, 2016) – Researchers from the Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Columbia Universal Medical Center have found that the sickle cell trait is not associated with an increased risk of heart failure or abnormalities of cardiac structure and function in African Americans.
In a study published in Blood on Dec. 8, 2016, researchers analyzed data from four longitudinal cohorts with a combined sample of more than 15,000 African Americans, 1,216 with sickle cell trait—and determined that sickle cell trait is not independently associated with an increased risk of heart failure.
"We know that individuals who have sickle cell disease have an increased risk for abnormal heart structure and function, which results in poor cardiovascular outcomes,” said Co-Lead Study Author Natalie Bello, MD, MPH, of the Columbia University Medical Center in New York. “We conducted this study because there is a lack of information about the heart structure, and function of people with sickle cell trait and their risk of developing heart failure.”
Dr. Bello and her colleagues conducted a meta-analysis of the incidence of heart failure from four independent population-based cohorts in the United States. The prevalence of sickle cell trait among the cohorts ranged from 7-9% and was consistent with population prevalence estimates in African Americans.
The researchers found that individuals with sickle cell trait had no greater risk of developing heart failure compared to those individuals without sickle cell trait. Heart failure was observed in 7.6% of the sickle cell trait carriers compared to 8.6% of the non-carriers. There were also no significant differences in cardiac structure and function, including no observed differences in abnormalities of left ventricular size, thickness or systolic function. Additionally, recognizing that sickle cell trait results in a higher incidence of blood clots and pulmonary embolism, the team looked for signs of increased stress on the right ventricle, which could see greater stress and higher pressure from presence of blood clots, but found none.
“What is significant about this study is that it is the first of its kind and more representative of the African American population, in the United States compared to earlier studies” said Hyacinth I. Hyacinth, MD, PhD, MPH, Co-Lead Study Author at the Aflac Cancer and Blood Disorder Center and Emory University School of Medicine. “Not only does the sample reflect the rate of sickle cell trait that we see nationwide, but we also saw very similar rates of obesity, hypertension and diabetes.”
The cohorts that contributed to this study include Atherosclerosis Risk in Communities Study (ARIC), Jackson Heart Study (JHS), Multi-Ethnic Study of Atherosclerosis (MESA) and Women's Health Initiative (WHI). Additional analysis is being done on these data to assess the additional effects that sickle cell trait can have on cardiac events, such as myocardial infarction.