Age and prevalence of sickle‐cell trait in a large ambulatory population

Castro, Oswaldo; Rana, Sohail; Bang, Ki Moon; Scott, Roland B.

doi:10.1002/gepi.1370040409

Cited by 20 publications

(11 citation statements)

References 16 publications

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“…The participation rate of subjects, especially case patients, was somewhat low. However, the observation that the prevalence of SCT among our controls, 6.2%, is comparable with that observed (6.7%) in a large cross-sectional study of 30 400 healthy blacks in the Washington, DC, metropolitan area 9 suggests that the decision to participate in the study was not related to the sickle cell genotype. The observation that the SCT/VTE association was seen both for provoked and idiopathic cases contradicts the belief that the association is an artifact arising from the use of sick, hospitalized cases.…”

Section: Discussionmentioning

confidence: 54%

Sickle cell trait and the risk of venous thromboembolism among blacks

Austin

Key

Benson

et al. 2007

Blood

218

189

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People with sickle cell disease have a chronically activated coagulation system and display hemostatic perturbations, but it is unknown whether they experience an increased risk of venous thromboembolism. We conducted a case-control study of venous thromboembolism that included 515 hospitalized black patients and 555 black controls obtained from medical clinics. All subjects were assayed for hemoglobin S and hemoglobin C genotypes. The prevalence of the S allele was 0.070 and 0.032 for case patients and controls, respectively (P < .001). The odds that a patient had sickle cell trait were approximately twice that of a control, indicating that the risk of venous thromboembolism is increased approximately 2-fold among blacks with sickle cell trait compared with those with the wild-type genotype (odds ratio = 1.8 with 95% confidence interval, 1.2-2.9). The odds ratio for pulmonary embolism and sickle cell trait was higher, 3.9 (2.2-6.9). The prevalence of sickle cell disease was also increased among case patients compared with controls. We conclude that sickle cell trait is a risk factor for venous thromboembolism and that the proportion of venous thromboembolism among blacks attributable to the mutation is approximately 7%.

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Section: Discussionmentioning

confidence: 54%

Sickle cell trait and the risk of venous thromboembolism among blacks

Austin

Key

Benson

et al. 2007

Blood

218

189

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“…Several studies have described a higher rate of VTE in blacks and some have investigated the association of SCT with thromboembolic disease [6]–[11], [16]–[18]. In support of the hypercoagulability hypothesis, Westerman noted increased levels of prothrombotic markers such as D-dimers, TAT (thrombin-antithrombin complexes) and the prothrombin cleavage fragment F1.2 in patients with SCT compared to HbAA controls [27].…”

Section: Discussionmentioning

confidence: 95%

“…In support of the hypercoagulability hypothesis, Westerman noted increased levels of prothrombotic markers such as D-dimers, TAT (thrombin-antithrombin complexes) and the prothrombin cleavage fragment F1.2 in patients with SCT compared to HbAA controls [27]. Other investigations have attempted to link clinical incidence of VTE to SCT, suggesting that sickle cell trait may predispose to a higher occurrence of thrombotic events [16]–[18]. Early data from Heller at al.…”

Section: Discussionmentioning

confidence: 96%

Sickle Cell Trait: Is There an Increased VTE Risk in Pregnancy and the Postpartum?

2013

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Blacks are purported to have a higher venous thromboembolism (VTE) risk than whites. We hypothesized that this might be due, in part, to the greater presence of sickle cell trait (SCT) among blacks. We investigated whether the presence of SCT resulted in a higher VTE incidence in a population predisposed to VTE, the pregnant/postpartum women. Methods: Using a mirrored clinical database that prospectively gathered in- and out-patient information for the years 1998–2008, we collected demographic data, including hemoglobin electrophoreses, on all pregnant/postpartum non-Hispanic women who delivered at a large, diverse, urban hospital. We identified those women who developed VTE either while pregnant or postpartum during those 11 years. Charts initially identified as potential VTE cases were subjected to review to ensure accuracy of VTE coding. Results: Of 12,429 women, 679 non-Hispanic SCT black women, 5,465 non-Hispanic Hemoglobin AA (women with HbA as the only hemoglobin present on electrophoresis, with normal amounts of the minor hemoglobins) black women and 1,162 non-Hispanic HbAA white women were included in the analysis. SCT prevalence was high (11.1%) within this black population as compared to 8.3% in the general non-white population. Proportions with VTE were similar for black SCT and black HbAA groups: 0.44% for the SCT group, 0.49% for non-Hispanic black HbAA women. Black HbAA women had a non-significantly higher proportion of VTE than white HbAA women 0.49% vs 0.26% (RR 1.9, 95%CI:0.6,6.3, p = 0.28). Women with VTE were older than those without VTE (32.2 vs. 27.6 years, p = 0.0002) and the majority of VTE occurred postpartum in all groups, and significantly in the HbAA groups. There was no increase in the incidence of pulmonary emboli in the SCT group. Conclusion: In the largest analysis to date, we could not detect a meaningful difference in peripartum VTE incidence between women with and without sickle cell trait.

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“…As SCT does not affect survival, there is no reason to suspect that SCT rates change with age. Castro et al 17 found no association between age and SCT prevalence when they screened 30 400 apparently healthy black individuals in the Washington, DC Metropolitan Area, who were participating in a community-based sickle cell screening program. If, however, women are more likely to be screened when they are of child-bearing age, one may see a difference in self-reported SCT in younger women, who have been screened more recently.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of antenatal screening for sickle cell trait: the impact on women’s self-report of sickle cell trait status

Knight‐Madden

Reid

Younger

et al. 2012

Pathogens and Global Health

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Objectives: The sickle gene frequency in the Jamaican population has not changed over a generation. It is unknown whether routine antenatal screening for sickle cell trait (SCT) has affected women's knowledge of their SCT status. The aim of this study was to compare the prevalence of self-reported SCT in parous women to the prevalence in nulliparous women, men and to the observed prevalence of SCT measured in an antenatal clinic. Methods: All participants in the nationally representative Jamaica Health and Lifestyle Survey 2008 were asked whether they had the SCT. The impact of gender, age, educational attainment, geographical location, and pregnancy on self-reported SCT were assessed. The prevalence of SCT in women attending a large antenatal clinic concurrently was compared to that reported by women of child-bearing age in the lifestyle survey. Results: Self-report significantly underestimated the prevalence of SCT (2.9% versus 10.1%, P,0.001). Those with secondary education were more likely than those with presecondary education (P50.01) and women more likely than men (3.2% versus 1.1%, P50.001) to report having SCT. Women who had been pregnant were no more likely than other women to report having SCT (3.1% versus 4.1%, P50.4). Conclusions: Attendance at antenatal clinic where SCT screening is routine, is not associated with increased self-report of SCT. Screening programs must ensure that, as well as technically accurate screening, there is effective communication of the results of screening for SCT to those tested to help reduce the public health burden of sickle cell disease in tropical countries.

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Age and prevalence of sickle‐cell trait in a large ambulatory population

Cited by 20 publications

References 16 publications

Sickle cell trait and the risk of venous thromboembolism among blacks

Sickle cell trait and the risk of venous thromboembolism among blacks

Sickle Cell Trait: Is There an Increased VTE Risk in Pregnancy and the Postpartum?

Effectiveness of antenatal screening for sickle cell trait: the impact on women’s self-report of sickle cell trait status

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