On improvement in ejection fraction with iron chelation in thalassemia major and the risk of future heart failure
2011

Iron Chelation and Heart Health in Thalassemia Major

Sample size: 315 publication 10 minutes Evidence: high

Author Information

Author(s): Pennell DJ, Carpenter JP, Roughton M, Cabantchik ZI

Primary Institution: Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, London UK

Hypothesis

Does improvement in ejection fraction with iron chelation reduce the risk of future heart failure in thalassemia major patients?

Conclusion

Small increases in left ventricular ejection fraction during iron chelation treatment are associated with a significantly reduced risk of developing heart failure in thalassemia major patients.

Supporting Evidence

  • A 1% increase in ejection fraction was linked to an 18.2% reduction in heart failure risk for patients with baseline EF 56-62%.
  • A 1% increase in ejection fraction was linked to a 10.7% reduction in heart failure risk for patients with baseline EF 63-70%.
  • Improvements in ejection fraction of 2.6% to 3.1% observed in trials correspond to significant risk reductions for heart failure.

Takeaway

If kids with thalassemia get better at pumping blood, they are less likely to have heart problems later on.

Methodology

This retrospective study analyzed changes in ejection fraction from cardiovascular magnetic resonance scans in thalassemia major patients and their association with heart failure risk over 12 months.

Potential Biases

Potential biases may arise from the retrospective nature of the study and the selection of patients from a single database.

Limitations

The study is retrospective and relies on existing database records, which may have incomplete data.

Participant Demographics

{"age":"26.6 (8.6)","sex":{"male":"54.1%","female":"45.9%"},"ethnicity":{"Indian":"28.4%","Greek":"16.5%","Cypriot":"15.6%","Pakistani/Bangladeshi":"12.8%","Turkish/Arabic":"11.0%","Italian/Romanian":"5.5%","Chinese/Malay":"4.6%","Unknown":"6.4%"}}

Statistical Information

P-Value

<0.001

Confidence Interval

{"56-62%":"0.767 to 0.872","63-70%":"0.836 to 0.953"}

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1532-429X-13-45

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