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

Abstract 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)...

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Main Authors: Jean Jacques Noubiap, Mazou N. Temgoua, Ronni Tankeu, Joel Noutakdie Tochie, Ambroise Wonkam, Jean Joël Bigna
Format: Article
Language:English
Published: BMC 2018-10-01
Series:Thrombosis Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12959-018-0179-z
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spelling doaj-8cfdcec591444a5698208153db1ee48d2020-11-25T02:05:57ZengBMCThrombosis Journal1477-95602018-10-011611810.1186/s12959-018-0179-zSickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysisJean Jacques Noubiap0Mazou N. Temgoua1Ronni Tankeu2Joel Noutakdie Tochie3Ambroise Wonkam4Jean Joël Bigna5Department of Medicine, Groote Schuur Hospital and University of Cape TownDepartment of Internal Medicine and sub-Specialties, Faculty of Medicine and Biomedical SciencesDepartment of Internal Medicine and sub-Specialties, Faculty of Medicine and Biomedical SciencesDepartment of Surgery and sub-Specialties, Faculty of Medicine and Biomedical SciencesDivision of Human Genetics, Faculty of Health Sciences, University of Cape TownDepartment of Epidemiology and Public Health, Centre Pasteur of CameroonAbstract 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.http://link.springer.com/article/10.1186/s12959-018-0179-zSickle cell diseaseSickle cell anemiaSickle cell traitVenous thromboembolismPulmonary embolismDeep vein thrombosis
collection DOAJ
language English
format Article
sources DOAJ
author Jean Jacques Noubiap
Mazou N. Temgoua
Ronni Tankeu
Joel Noutakdie Tochie
Ambroise Wonkam
Jean Joël Bigna
spellingShingle Jean Jacques Noubiap
Mazou N. Temgoua
Ronni Tankeu
Joel Noutakdie Tochie
Ambroise Wonkam
Jean Joël Bigna
Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
Thrombosis Journal
Sickle cell disease
Sickle cell anemia
Sickle cell trait
Venous thromboembolism
Pulmonary embolism
Deep vein thrombosis
author_facet Jean Jacques Noubiap
Mazou N. Temgoua
Ronni Tankeu
Joel Noutakdie Tochie
Ambroise Wonkam
Jean Joël Bigna
author_sort Jean Jacques Noubiap
title Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
title_short Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
title_full Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
title_fullStr Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
title_full_unstemmed Sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
title_sort sickle cell disease, sickle trait and the risk for venous thromboembolism: a systematic review and meta-analysis
publisher BMC
series Thrombosis Journal
issn 1477-9560
publishDate 2018-10-01
description Abstract 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.
topic Sickle cell disease
Sickle cell anemia
Sickle cell trait
Venous thromboembolism
Pulmonary embolism
Deep vein thrombosis
url http://link.springer.com/article/10.1186/s12959-018-0179-z
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