Characteristics and outcomes of stroke hospitalizations in patients with sickle cell disease and moyamoya syndrome

Rallo, Michael S.; Akel, Omar; Kalakoti, Piyush; Sun, Hai

doi:10.1016/j.jstrokecerebrovasdis.2022.106705

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…Similar results were reported by Oniyangi et al, in which 5 SCD patients suffered a stroke after being placed on HU therapy [ 18 ]. Several factors are associated with the poor performance of HU including poor medication adherence, uses of incorrect doses, duration of HU uses, age, and comorbidities [ 17 , 27 , 28 ]. In addition, the recurrence of stroke episodes after using HU among SCD patients could be attributed to the occurrence of polymorphisms in the genes associated with its pharmacological effects and pharmacokinetics parameters.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Stroke in Individuals with Sickle Cell Disease Pre‐ and during Hydroxyurea Uses: A Descriptive Cross‐Sectional Study in Tanzania

Moshi,

Philipo,

Kileo

et al. 2024

Advances in Hematology

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Sickle cell disease (SCD) is an inherited blood disorder that leads to a variety of complications, including stroke. The use of hydroxyurea (HU) is reported to lessen the frequency and burden of stroke in SCD patients. However, less is known about the prevalence of stroke in SCD patients pre- and during the use of HU in sub-Saharan African (SSA) countries. Therefore, the study assessed stroke prevalence before and during uses of hydroxyurea among SCD patients in Tanzania. A hospital-based descriptive cross-sectional study was conducted at the sickle cell clinics in Dar es Salaam, Tanzania, from April 2023 to May 2023. A total of 228 participants were recruited, and data on demographic and clinical characteristics, HU use, and history of stroke were collected using a checklist from the respective patients’ medical records and verbal communication with the patients or caregivers. Data analysis was done using SPSS software version 25, and findings are summarized using frequency and percentages. Out of 228 enrolled SCD patients, 124 (54.4%) were females, 109 (47.8%) were aged between 6 and 12 years, 226 (99.1%) were not married, 181 (79.4%) had primary education, and 209 (95%) were unemployed. The prevalence of stroke pre-HU use was 28 (12.3%) and 6 (2.6%) after starting using HU. Out of 6 with stroke after starting using HU, 3 (50%) had a history of stroke pre-HU uses. The study showed that the prevalence of stroke among SCD patients is significantly reduced after HU use. The findings suggest the need for stakeholders to implement measures to ensure eligible SCD patients are kept on HU.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Stroke in Individuals with Sickle Cell Disease Pre‐ and during Hydroxyurea Uses: A Descriptive Cross‐Sectional Study in Tanzania

Moshi,

Philipo,

Kileo

et al. 2024

Advances in Hematology

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Stroke in sickle cell patients, epidemiology, pathophysiology, systemic and surgical treatment options and prevention strategies

Shah,

Alberts,

Ngo

et al. 2024

Clinical and Translational Dis

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BackgroundA hereditary haemoglobinopathy known as sickle cell disease (SCD) affects over 100 000 people in the United States severely. Cerebrovascular disease is a prominent consequence of SCD. By the age of 30, 53% of patients have silent cerebral infarcts (SCIs) (a stroke that occurs without any obvious symptoms because it damages a small part of the brain that isn't responsible for any essential functions), and by the age of 40, 3.8% have overt strokes.Main bodyThe multidimensional burden of cerebrovascular illness in SCD is reviewed in detail in this article, which includes both clinical strokes and the frequently asymptomatic SCIs. The intricate pathophysiology of SCD and stroke is explored. With SCD, there are currently very few methods for preventing primary and secondary stroke; the most common ones are hydroxyurea and blood transfusion. Nevertheless, not enough research has been done on the possible contributions of anticoagulation and aspirin to strokes linked to SCD. Promising evidence is also highlighted in the study, suggesting that new drugs intended to treat SCD may be able to alleviate leg ulcers and renal impairment in addition to reducing unusually high transcranial Doppler flow velocity – a crucial component of cerebrovascular events. Given that these novel medications specifically target haemolysis and vaso‐occlusion, the two main causes of strokes in this population, more research is desperately needed to determine whether they are effective in avoiding strokes in people with SCD. The literature review also emphasizes how common healthcare inequities are and how they hinder advancements in SCD research and management in the United States.ConclusionTo successfully address these inequities, the evaluation recommends more funding for both SCD management and research, as well as for patient and clinician education. This multimodal viewpoint highlights the intricate terrain of cerebrovascular problems associated with SCD and the urgent need for all‐encompassing and fair strategies to improve patient outcomes and advance research.

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Stroke Prevention and Treatment for Youth with Sickle Cell Anemia: Current Practice and Challenges and Promises for the Future

Creary,

Chung,

Villella

et al. 2024

Curr Neurol Neurosci Rep

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Purpose of Review Sickle cell anemia (SCA) is an autosomal recessive inherited hemoglobinopathy that results in a high risk of stroke. SCA primarily affects an underserved minority population of children who are frequently not receiving effective, multi-disciplinary, preventative care. This article reviews primary and secondary stroke prevention and treatment for children with SCA for the general adult and pediatric neurologist, who may play an important role in providing critical neurologic evaluation and care to these children. Recent Findings Primary stroke prevention is efficacious at reducing ischemic stroke risk, but it is not consistently implemented into clinical practice in the United States, resulting in these children remaining at high risk. Acute symptomatic stroke management requires neurology involvement and emergent transfusion to limit ischemia. Furthermore, while chronic transfusion therapy is a proven secondary preventative modality for those with prior symptomatic or silent cerebral infarcts, it carries significant burden. Newer therapies (e.g., stem cell therapies and voxelotor) deserve further study as they may hold promise in reducing stroke risk and treatment burden. Summary Effective primary and secondary stroke prevention and treatment remain a challenge. Informing and engaging neurology providers to recognize and provide critical neurologic evaluation and treatment has potential to close care gaps.

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Characteristics and outcomes of stroke hospitalizations in patients with sickle cell disease and moyamoya syndrome

Cited by 3 publications

References 29 publications

Prevalence of Stroke in Individuals with Sickle Cell Disease Pre‐ and during Hydroxyurea Uses: A Descriptive Cross‐Sectional Study in Tanzania

Prevalence of Stroke in Individuals with Sickle Cell Disease Pre‐ and during Hydroxyurea Uses: A Descriptive Cross‐Sectional Study in Tanzania

Stroke in sickle cell patients, epidemiology, pathophysiology, systemic and surgical treatment options and prevention strategies

Stroke Prevention and Treatment for Youth with Sickle Cell Anemia: Current Practice and Challenges and Promises for the Future

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