Increased risk of arterial thromboembolic events in transfusion-na?ve thalassemia: a nationwide population-based study
Journal
Journal of Investigative Medicine
Journal Volume
67
Journal Issue
5
Pages
826-832
Date Issued
2019
Author(s)
Abstract
Transfusion-na?ve thalassemia minor/trait is often associated with decreased risk of coronary artery diseases. The present study aimed to evaluate the effect of transfusion-na?ve thalassemia on the incidence of arterial thromboembolic events using the National Health Insurance Research Database, Taiwan (2001-2010). Data from patients with transfusion-na?ve thalassemia (n=2356) frequency matched with non-thalassemia subjects (n=9424) according to sex, age, and index year at a ratio of 1:4 were included. The risk of arterial thromboembolic events, cerebrovascular ischemic events, arterial embolism/thrombosis, peripheral embolism, myocardial infarction, myocardial ischemia, and angina pectoris in transfusion-na?ve thalassemia were analyzed using Cox proportional hazard regression models. The transfusion-na?ve thalassemia group had significantly higher risk of arterial thromboembolic events (aHR=1.28, 95% CI 1.07 to 1.52) and myocardial ischemia (aHR=1.41, 95% CI 1.13 to 1.76) as compared with the non-thalassemia group. In addition, they also had a significantly higher cumulative incidence of arterial thromboembolic event and myocardial ischemia. Interestingly, a higher risk of arterial thromboembolic events (aHR=1.58, 95% CI 1.22 to 2.04) and myocardial ischemia (aHR=1.73, 95% CI 1.25 to 2.41) was observed in men with thalassemia as compared with those without. Furthermore, patients with comorbidities had an increased risk of arterial thromboembolic events than did those without comorbidities. The effect of thalassemia on arterial thromboembolic events may be mainly attributed to the influence of thalassemia on myocardial ischemia, as no significant differences were observed in other outcomes evaluated in the present study. In conclusion, the present study confirms the increased risk of arterial thromboembolic events, mainly attributed to the dramatic increase in myocardial ischemia, inminor patients with transfusion-na?ve thalassemia. ? American Federation for Medical Research 2019.
Subjects
adult; angina pectoris; arterial thromboembolism; artery embolism; artery thrombosis; Article; blood transfusion; brain ischemia; comorbidity; controlled study; female; heart infarction; heart muscle ischemia; human; incidence; major clinical study; male; risk assessment; risk factor; sex difference; Taiwan; thalassemia; artery; case control study; complication; pathology; thalassemia; thromboembolism; Adult; Arteries; Blood Transfusion; Case-Control Studies; Female; Humans; Incidence; Male; Risk Factors; Thalassemia; Thromboembolism
SDGs
Type
journal article