Nouraie et al identified factors associated with a high risk for vascular complications in a patient with sickle cell disease. A patient with vascular complications is at increased risk for morbidity and mortality. The authors are from the University of Pittsburgh, University of North Carolina, Imperial College London, Emory University, Indiana University and the University of Illinois.

Patient selection: adult with sickle cell anemia


Vascular complications: pulmonary hypertension, diastolic left heart disease, nephropathy


Risk factors for vascular disease:

(1) chronic kidney disease (eGFR < 90 or urine albumin-to-creatinine ratio > 300)

(2) tricuspid regurgitation velocity (TRV) >= 2.5 m/s and BNP >= 160 pg/mL

(3) TRV >= 3.0 m/s


If any of these factors are present then the hazard ratio for high-risk vascular disease is 5.38.


Additional clinical findings:

(1) older age

(2) greater anemia

(3) low functional capacity

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