Risk for Stroke, TIA Increased in Adults With Sickle Cell Disease
WEDNESDAY, Sept. 25, 2024 -- Adults with sickle cell disease (SCD) have an increased risk for stroke and transient ischemic attack (TIA), according to a study published online Sept. 20 in Blood.
Olubusola Oluwole, M.D., from the University of Pittsburgh, and colleagues determined the cumulative incidence and rates for primary and recurrent strokes and TIAs in people with SCD before and after the STOP trial of 1998, which established chronic transfusions as the standard of care for children with SCD at high risk for stroke. The cohort included 7,636 patients with SCD.
The researchers found that the cumulative incidence was 2.1 and 13.5 percent for first ischemic stroke by age 20 years and by age 60 years, respectively. The corresponding cumulative incidence for first intracranial hemorrhage was 0.5 and 6.8 percent, respectively. Compared with the preceding decade, in 2010 to 2019, there was an increase in ischemic stroke rates in children (younger than 18 years: 234.9 versus 165.1 per 100,000 person-years) and adults (31 to 50 years: 431.1 versus 303.2 per 100,000 person-years). Compared with the previous decade, in 2010 to 2019 the rates of intracranial hemorrhage increased in those aged 18 to 30 years and TIA increased in children younger than 18 years. Older age, hypertension, and hyperlipidemia were risk factors for stroke and TIA.
"As people with SCD live longer, there remains an unmet need to develop guidelines for primary and secondary stroke prevention in adults at highest risk for neurological debility from adverse cerebrovascular events," the authors write.
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