A study of carotid intima media thickness among thalassemia patient in HUSM

• Main Author: Zaidin Samsudin, Ahmad Hadif
• Format: Thesis
• Language: English
• Published: 2015
• Subjects: RC666-701 Diseases of the circulatory (Cardiovascular) system
• Online Access: http://eprints.usm.my/39717/1/Dr_Ahmad_Hadif_Zaidin_Samsudin_%28RC71-78.1%29-24_pages.pdf; http://eprints.usm.my/39717/

Background: Thalassemia patient lifespan nowadays has been increased significantly compared to previously due to the advancement of medical treatment and better healthcare system. As a result, more transfusion-related complications are seen, and one of the rising trends is the thromboembolic complication. Studies has shown that ultrasound measurement of carotid intima-media thickness (CIMT) can be used as a surrogate marker for future cardiovascular event and is recommended to be done in thalassemia patient as early diagnostic tool and for vascular risk stratification. Objectives: To compare CIMT measurement between thalassemia patients in HUSM with the non- thalassemia population and to find any association between CIMT measurement with patient’s age, disease duration, numbers of blood transfusions and serum ferritin level. Methodology: A cross sectional study was done over a period of 19 months from January 2013 until August 2014. A single operator performed the ultrasound examination using 18 Mhzlinear array transducer (Siemen Acuson S2000) at Department of Radiology, Hospital Universiti Sains Malaysia (HUSM). All thalassemia patient who is receiving treatment and follow-up at HUSM and consented for the examination, were subjected to the measurement of their carotid intima-media thickness (CIMT). Patient age, disease duration, numbers of blood transfusion and serum ferritin level were obtained and recorded. The same numbers of healthy subject were recruited from the general population and their CIMT were also recorded. Result: A total of 80 subjects were included in this study with the equal number of thalassemia patients and the non- thalassemia population. The mean value of CIMT for the non- thalassemia population was 0.32± 0.08mm and that of thalassemia patient was 0.45± 0.10mm. Independent t-test showed statistically significant difference between these two measurements (p<0.001). On univariate analysis, there was a strong correlation between thalassemia CIMT measurement and disease duration and number of blood transfusions. However multivariate analysis showed only the number of blood transfusion was significantly correlated with patient CIMT measurement. Increased in the number of blood transfusion by 100 times would increase the mean CIMT by 1.0mm. Conclusion: The finding of higher mean value of CIMT in thalassemia patient might be suggestive for an increased in future cardiovascular and cerebrovascular event in thalassemia patient compared to non- thalassemia population and it is significantly associated with the number of blood transfusion.