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Sickle cell trait increased risk for pulmonary embolism
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African Americans with sickle cell trait appeared twice as likely to develop pulmonary embolism as those who did not carry sickle cell trait, according to study results.
However, sickle cell trait was not associated with increased risk for deep vein thrombosis, results showed.
Prior research has suggested that sickle cell trait may increase risk for venous thromboembolism (VTE), but the association has not been fully established, according to background information provided by researchers.
Aaron M. Folsom, MD, of the division of epidemiology and community health at the University of Minnesota’s School of Public Health, and colleagues evaluated data on 4,016 middle-aged African Americans who participated in the prospective Atherosclerosis Risk in Communities Study. Of these patients, 268 (6.6%) had sickle cell trait and 3,748 did not.
Median follow-up was 22 years. During that time, 249 participants developed incident VTE. Of these, 111 were incident hospitalized pulmonary embolism (PE) and 138 were isolated deep vein thrombosis (DVT).
After adjustments for age, gender, ancestry, BMI, diabetes, estimated glomerular filtration rate and receipt of hormone replacement therapy among women, Folsom and colleagues determined participants with sickle cell trait were more likely to develop VTE than those who did not carry sickle cell trait (HR=1.5; 95% CI, 0.96-2.36).
Participants with sickle cell trait were more than twice as likely to develop PE (HR=2.05; 95% CI, 1.12-3.76), whereas the risk for DVT without PE was less pronounced (HR=1.15; 95% CI, 0.58-2.27).
“Because neonatal screening for sickle hemoglobin is being conducted in the United States … consideration should be paid to the increased pulmonary embolism risk of individuals with sickle cell trait,” Folsom and colleagues concluded.