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Cardiac complications and diabetes in thalassaemia major: a large historical multicentre study
Author(s) -
Pepe Alessia,
Meloni Antonella,
Rossi Giuseppe,
Caruso Vincenzo,
Cuccia Liana,
Spasiano Anna,
Gerardi Calogera,
Zuccarelli Angelo,
D'Ascola Domenico G.,
Grimaldi Salvatore,
Santodirocco Michele,
Campisi Saveria,
Lai Maria E.,
Piraino Basilia,
Chiodi Elisabetta,
Ascioti Claudio,
Gulino Letizia,
Positano Vincenzo,
Lombardi Massimo,
Gamberini Maria R.
Publication year - 2013
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.12557
Subject(s) - medicine , diabetes mellitus , myocardial fibrosis , cardiology , heart failure , odds ratio , retrospective cohort study , cardiac fibrosis , endocrinology
Summary The relationship between diabetes mellitus ( DM ) and cardiac complications has never been systematically studied in thalassaemia major ( TM ). We evaluated a large retrospective historical cohort of TM to determine whether DM is associated with a higher risk of heart complications. We compared 86 TM patients affected by DM with 709 TM patients without DM consecutively included in the Myocardial Iron Overload in Thalassaemia database where clinical/instrumental data are recorded from birth to the first cardiovascular magnetic resonance ( CMR ) exam. All of the cardiac events considered were developed after the DM diagnosis. In DM patients versus non‐ DM patients we found a significantly higher frequency of cardiac complications (46·5% vs. 16·9%, P < 0·0001), heart failure ( HF ) (30·2% vs. 11·7%, P < 0·0001), hyperkinetic arrhythmias (18·6% vs. 5·5%, P < 0·0001) and myocardial fibrosis assessed by late gadolinium enhancement (29·9% vs. 18·4%, P = 0·008). TM patients with DM had a significantly higher risk of cardiac complications [odds ratio ( OR ) 2·84, P < 0·0001], HF ( OR 2·32, P = 0·003), hyperkinetic arrhythmias ( OR 2·21, P = 0·023) and myocardial fibrosis ( OR 1·91, P = 0·021), also adjusting for the absence of myocardial iron overload assessed by T2* CMR and for the covariates (age and/or endocrine co‐morbidity). In conclusion, DM significantly increases the risk for cardiac complications, HF , hyperkinetic arrhythmias and myocardial fibrosis in TM patients.