Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis

dc.contributor.authorNoubiap, Jean J
dc.contributor.authorTemgoua, Mazou N
dc.contributor.authorTankeu, Ronni
dc.contributor.authorTochie, Joel Noutakdie
dc.contributor.authorWonkam, Ambroise
dc.contributor.authorBigna, Jean Joël
dc.date.accessioned2018-10-08T06:06:49Z
dc.date.available2018-10-08T06:06:49Z
dc.date.issued2018-10-04
dc.date.updated2018-10-07T03:19:16Z
dc.description.abstractBackground Globally, sickle cell disease (SCD) is one of the most common haemoglobinopathy. Considered a public health problem, it leads to vessel occlusion, blood stasis and chronic activation of the coagulation system responsible for vaso-occlussive crises and venous thromboembolism (VTE) which may be fatal. Although contemporary observational studies suggest a relationship between SCD or sickle trait (SCT) and VTE, there is lack of a summary or meta-analysis data on this possible correlation. Hence, we propose to summarize the available evidence on the association between SCD, SCT and VTE including deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods We searched PubMed and Scopus to identify all cross-sectional, cohort and case-control studies reporting on the association between SCD or SCT and VTE, DVT or PE in adults or children from inception to April 25, 2017. For measuring association between SCD or SCT and VTE, DVT, or PE, a meta-analysis using the random-effects method was performed to pool weighted odds ratios (OR) of risk estimates. Results From 313 records initially identified from bibliographic databases, 10 studies were eligible and therefore included the meta-analysis. SCD patients had significantly higher risk for VTE (pooled OR 4.4, 95%CI 2.6–7.5, p < 0.001), DVT (OR 1.1, 95% CI 1.1–1.2, p < 0.001) and PE (pooled OR 3.7, 95% CI 3.6–3.8, p < 0.001) as compared to non SCD-adults. A higher risk of VTE (OR 33.2, 95% CI 9.7–113.4, p < 0.001) and DVT (OR 30.7, 95% CI 1.6–578.2, p = 0.02) was found in pregnant or postpartum women with SCD as compared to their counterparts without SCD. Compared to adults with SCT, the risk of VTE was higher in adults with SCD (pooled OR 3.1, 95% CI 1.8–5.3, p < 0.001), and specifically in SCD pregnant or postpartum women (OR 20.3, 95% CI 4.1–102, p = 0.0003). The risk of PE was also higher in adults with SCD (OR 3.1, 95% CCI 1.7–5.9, p = 0.0004) as compared to those with SCT. The risk of VTE was higher in individuals with SCT compared to controls (pooled OR 1.7, 95% CI 1.3–2.2, p < 0.0001), but not in pregnant or postpartum women (OR 0.9, 95% CI 0.3–2.9, p = 0.863). Compared to controls, SCT was associated with a higher risk of PE (pooled OR 2.1, 95% CI 1.2–3.8, p = 0.012) but not of DVT (pooled OR 1.2, 95% CI 0.9–1.7, p = 0.157). Conclusion Individuals with SCD, especially pregnant or postpartum women, might have a higher risk of VTE compared to the general population. SCT might also increases the risk of VTE. However, currently available data are not sufficient to allow a definite conclusion. Further larger studies are needed to provide a definitive conclusion on the association between SCD, SCT and VTE.
dc.identifier.apacitationNoubiap, J. J., Temgoua, M. N., Tankeu, R., Tochie, J. N., Wonkam, A., & Bigna, J. J. (2018). Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis. http://hdl.handle.net/11427/28913en_ZA
dc.identifier.chicagocitationNoubiap, Jean J, Mazou N Temgoua, Ronni Tankeu, Joel Noutakdie Tochie, Ambroise Wonkam, and Jean Joël Bigna "Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis." (2018) http://hdl.handle.net/11427/28913en_ZA
dc.identifier.citationNoubiap, J.J., Temgoua, M.N., Tankeu, R.T., Tochie, J.N., Wonkam, A., & Bigna, J.J. 2018. Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis. Thrombosis Journal.16(1):27
dc.identifier.ris TY - Journal Article AU - Noubiap, Jean J AU - Temgoua, Mazou N AU - Tankeu, Ronni AU - Tochie, Joel Noutakdie AU - Wonkam, Ambroise AU - Bigna, Jean Joël AB - Background Globally, sickle cell disease (SCD) is one of the most common haemoglobinopathy. Considered a public health problem, it leads to vessel occlusion, blood stasis and chronic activation of the coagulation system responsible for vaso-occlussive crises and venous thromboembolism (VTE) which may be fatal. Although contemporary observational studies suggest a relationship between SCD or sickle trait (SCT) and VTE, there is lack of a summary or meta-analysis data on this possible correlation. Hence, we propose to summarize the available evidence on the association between SCD, SCT and VTE including deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods We searched PubMed and Scopus to identify all cross-sectional, cohort and case-control studies reporting on the association between SCD or SCT and VTE, DVT or PE in adults or children from inception to April 25, 2017. For measuring association between SCD or SCT and VTE, DVT, or PE, a meta-analysis using the random-effects method was performed to pool weighted odds ratios (OR) of risk estimates. Results From 313 records initially identified from bibliographic databases, 10 studies were eligible and therefore included the meta-analysis. SCD patients had significantly higher risk for VTE (pooled OR 4.4, 95%CI 2.6–7.5, p < 0.001), DVT (OR 1.1, 95% CI 1.1–1.2, p < 0.001) and PE (pooled OR 3.7, 95% CI 3.6–3.8, p < 0.001) as compared to non SCD-adults. A higher risk of VTE (OR 33.2, 95% CI 9.7–113.4, p < 0.001) and DVT (OR 30.7, 95% CI 1.6–578.2, p = 0.02) was found in pregnant or postpartum women with SCD as compared to their counterparts without SCD. Compared to adults with SCT, the risk of VTE was higher in adults with SCD (pooled OR 3.1, 95% CI 1.8–5.3, p < 0.001), and specifically in SCD pregnant or postpartum women (OR 20.3, 95% CI 4.1–102, p = 0.0003). The risk of PE was also higher in adults with SCD (OR 3.1, 95% CCI 1.7–5.9, p = 0.0004) as compared to those with SCT. The risk of VTE was higher in individuals with SCT compared to controls (pooled OR 1.7, 95% CI 1.3–2.2, p < 0.0001), but not in pregnant or postpartum women (OR 0.9, 95% CI 0.3–2.9, p = 0.863). Compared to controls, SCT was associated with a higher risk of PE (pooled OR 2.1, 95% CI 1.2–3.8, p = 0.012) but not of DVT (pooled OR 1.2, 95% CI 0.9–1.7, p = 0.157). Conclusion Individuals with SCD, especially pregnant or postpartum women, might have a higher risk of VTE compared to the general population. SCT might also increases the risk of VTE. However, currently available data are not sufficient to allow a definite conclusion. Further larger studies are needed to provide a definitive conclusion on the association between SCD, SCT and VTE. DA - 2018-10-04 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis TI - Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis UR - http://hdl.handle.net/11427/28913 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12959-018-0179-z
dc.identifier.urihttp://hdl.handle.net/11427/28913
dc.identifier.vancouvercitationNoubiap JJ, Temgoua MN, Tankeu R, Tochie JN, Wonkam A, Bigna JJ. Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis. 2018; http://hdl.handle.net/11427/28913.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.subject.otherSickle cell disease
dc.subject.otherSickle cell anemia
dc.subject.otherSickle cell trait
dc.subject.otherVenous thromboembolism
dc.subject.otherPulmonary embolism
dc.subject.otherDeep vein thrombosis
dc.titleSickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
dc.typeJournal Article
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