Association of Sickle Cell Trait With Incidence of Coronary Heart Disease Among African American Individuals

Hyacinth, Hyacinth I.; Franceschini, Nora; Seals, Samantha R.; Irvin, Marguerite R.; Chaudhary, Ninad S.; Naik, Rakhi P.; Alonso, Álvaro; Carty, Cara L.; Burke, Gregory L.; Zakai, Neil A.; Winkler, Cheryl A.; David, Victor A.; Kopp, Jeffrey B.; Judd, Suzanne E.; Adams, Robert J.; Gee, Beatrice E.; Longstreth, W. T.; Egede, Leonard E.; Lackland, Daniel T.; Greenberg, Charles S.; Taylor, Herman A.; Manson, Jo Ann E.; Key, Nigel S.; Derebail, Vimal K.; Kshirsagar, Abhijit V.; Folsom, Aaron R.; Konety, Suma; Howard, Virginia J.; Allison, Matthew; Wilson, James G.; Correa, Adolfo; Zhi, Degui; Arnett, Donna K.; Howard, George; Reiner, Alexander P.; Cushman, Mary; Safford, Monika M.

doi:10.1001/jamanetworkopen.2020.30435

Cited by 7 publications

(4 citation statements)

References 57 publications

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“…This was done based on the premise that previous studies showed no significant differences in comorbidities between those with sickle cell trait and those who do not have sickle cell trait, except for venous thromboembolism/pulmonary embolism. [10][11][12] We varied the size of the subgroup from 1000 to 3000. All outcomes were compared between the enhanced sickle cell trait group and Black patients without sickle cell disease or trait using the methodology described in "Analyses.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

COVID-19 in individuals with sickle cell disease/trait compared with other Black individuals

2021

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In the United States, COVID-19 has disproportionately affected Black persons. Sickle cell disease (SCD) and sickle cell trait (SCT) are genetic conditions that occur predominantly among Black individuals. It is unknown if individuals with SCD/SCT are at higher risk of severe COVID-19 illness compared with Black individuals who do not have SCD/SCT. The objective of our study was to compare COVID-19 outcomes, including the disease manifestations, hospitalization, and death, among individuals with SCD/SCT vs Black individuals who do not have SCD/SCT. We leveraged electronic health record data from a multisite research network to identify Black patients with COVID-19 who have SCD/SCT and those who do not have SCD/SCT. During the study period of 20 January 2020 to 20 September 2020, there were 312 patients with COVID-19 and SCD and 449 patients with COVID-19 and SCT. There were 45 517 Black persons who were diagnosed with COVID-19 but who did not have SCD/SCT. After 1:1 propensity score matching (based on age, sex, and other preexisting comorbidities), patients with COVID-19 and SCD remained at a higher risk of hospitalization (relative risk [RR], 2.0; 95% CI, 1.5-2.7) and development of pneumonia (RR, 2.4; 95% CI, 1.6-3.4) and pain (RR, 3.4; 95% CI, 2.5-4.8) compared with Black persons without SCD/SCT. The case fatality rates for those with SCD compared with Black persons without SCD/SCT were not significantly different. There also were no significant differences in COVID-19 outcomes between individuals with SCT and Black persons without SCD/SCT within the matched cohorts.

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Section: Sensitivity Analysesmentioning

confidence: 99%

COVID-19 in individuals with sickle cell disease/trait compared with other Black individuals

2021

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“…According to clinical evidence showing no association between SCT and the risk of developing heart disease [ 59 , 60 ], in our hands, the heart of SCT carrier mice has proven to be unaffected by microlesions at both light and ultrastructural levels. Nonetheless, the presence of endothelial luminal extroflexions resembles the morphological features observed in the spleen and shares similar characteristics to the human umbilical vein of SCT carrier mothers where the endothelial lining also showed an extended luminal profile with budding plasmalemmal vesicles [ 18 ].…”

Section: Discussionmentioning

confidence: 76%

Multi-Organ Morphological Findings in a Humanized Murine Model of Sickle Cell Trait

Trucas

Burattini

Porcu

et al. 2023

IJMS

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Sickle cell disease (SCD) is caused by the homozygous beta-globin gene mutation that can lead to ischemic multi-organ damage and consequently reduce life expectancy. On the other hand, sickle cell trait (SCT), the heterozygous beta-globin gene mutation, is still considered a benign condition. Although the mechanisms are not well understood, clinical evidence has recently shown that specific pathological symptoms can also be recognized in SCT carriers. So far, there are still scant data regarding the morphological modifications referable to possible multi-organ damage in the SCT condition. Therefore, after genotypic and hematological characterization, by conventional light microscopy and transmission electron microscopy (TEM), we investigated the presence of tissue alterations in 13 heterozygous Townes mice, one of the best-known animal models that, up to now, was used only for the study of the homozygous condition. We found that endothelial alterations, as among which the thickening of vessel basal lamina, are ubiquitous in the lung, liver, kidney, and spleen of SCT carrier mice. The lung shows the most significant alterations, with a distortion of the general tissue architecture, while the heart is the least affected. Collectively, our findings contribute novel data to the histopathological modifications at microscopic and ultrastructural levels, underlying the heterozygous beta-globin gene mutation, and indicate the translational suitability of the Townes model to characterize the features of multiple organ involvement in the SCT carriers.

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“…14 Although this mechanism of myocardial ischemia is associated with sickle cell trait/disease, the current literature does not support an association between sickle cell trait and increased risk of MI, at least in African American individuals. 15 Though an infrequent cause of MI that accounts for less than 1% of all acute MIs, 16 spontaneous coronary atery dissection (SCAD) was still important to consider in the differential diagnosis for the patient discussed in this case. Spontaneous coronary artery dissection (SCAD) is caused by a non-traumatic and non-iatrogenic separation of the epicardial coronary artery wall due to intramural hemorrhage.…”

Section: Discussionmentioning

confidence: 92%

Inferior STEMI electrocardiogram in a young postpartum female with sickle cell trait with chest pain - a case report

Truong¹,

Perdomo²,

Ng³

et al. 2022

JETEM

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Association of Sickle Cell Trait With Incidence of Coronary Heart Disease Among African American Individuals

Cited by 7 publications

References 57 publications

COVID-19 in individuals with sickle cell disease/trait compared with other Black individuals

COVID-19 in individuals with sickle cell disease/trait compared with other Black individuals

Multi-Organ Morphological Findings in a Humanized Murine Model of Sickle Cell Trait

Inferior STEMI electrocardiogram in a young postpartum female with sickle cell trait with chest pain - a case report

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