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Abstract
Background:
Atherosclerosis may be the
main cause of aging and death.
Methods:
All patients with sickle cell
diseases (SCD) were included.
Results:
We studied 222 males and 212
females with mean ages of
30.8 vs 30.3 years, p>0.05,
respectively. Smoking (23.8%
vs 6.1%, p<0.001), alcohol
(4.9% vs 0.4%, p<0.001),
transfused red blood cells
(RBC) in their lifespans (48.1
vs 28.5 units, p=0.000), disseminated
teeth losses (5.4% vs 1.4%,
p<0.001), ileus (7.2% vs
1.4%, p<0.001), cirrhosis
(8.1% vs 1.8%, p<0.001),
chronic obstructive pulmonary
disease (25.2% vs 7.0%, p<0.001),
coronary heart disease (CHD)
(18.0% vs 13.2%, p<0.05),
leg ulcers (19.8% vs 7.0%,
p<0.001), clubbing (14.8%
vs 6.6%, p<0.001), chronic
renal disease (9.9% vs 6.1%,
p<0.05), and stroke (12.1%
vs 7.5%, p<0.05) were all
higher in males.
Conclusion:
As an accelerated atherosclerotic
process, hardened RBC-induced
capillary endothelial damage
initiating at birth terminates
with multiorgan failures in
early years of life in the
SCD. Probably, stroke and
CHD are the main causes of
deaths even in the SCD. Probably,
hydroxyurea is the most effective
method of prevention of acute
painful crises. On the other
hand, RBC transfusions are
the most effective treatments
in acute painful crises both
to decrease the severity of
pain and to lower the risks
of sudden deaths, probably
due to the stroke or CHD,
again. Because of the increased
prevalences of allo-antibodies
parallel to the increased
number of transfusions, RBC
transfusions should be preserved
just for acute painful crises,
surgical operations, births,
and medical or surgical emergencies
in the SCD.
Key
words: Sickle cell diseases,
capillary endothelial inflammation,
acute painful crises, red
blood cell transfusion, accelerated
atherosclerosis, stroke, coronary
heart disease
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