Terminal endpoints of systemic atherosclerotic processes in sickle cell diseases

Abstract

Background: Sickle cell diseases (SCD) are severe inflammatory processes in the vasculature mainly on capillary endothelium since they are the main distributors of hardened red blood cells into the tissues. On the other hand, aging and male gender alone may be the most significant underlying risk factors of the systemic atherosclerosis since male gender lives about seven years shorter than female gender worldwide. Methods: All patients with the SCD were included into the study. Results: The study included 222 males and 212 females with similar mean ages (30.8 versus 30.3 years, p>0.05). Smoking (p<0.001), alcohol (p<0.001), disseminated teeth losses (p<0.001), ileus (p<0.001), cirrhosis (p<0.001), leg ulcers (p<0.001), digital clubbing (p<0.001), coronary heart disease (CHD) (p<0.05), chronic renal disease (CRD) (p<0.05), chronic obstructive pulmonary disease (COPD) (p<0.001), and stroke (p<0.05) were all higher in male gender. Interestingly, mean ages of stroke (33.5 years), COPD (33.6 years), clubbing (35.4 years), CHD (35.7 years), cirrhosis (37.0 years), and CRD (39.4 years) were the highest among the other atherosclerotic consequences. Conclusion: Smoking, alcohol, disseminated teeth losses, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, COPD, and stroke-like atherosclerotic risk factors or terminal endpoints were all higher in male gender with the SCD. Since aging alone may be the major associated factor of the systemic atherosclerosis, stroke, COPD, digital clubbing, CHD, cirrhosis, and CRD may be the terminal endpoints of systemic atherosclerotic processes in human body since the mean ages of the above pathologies were the highest among the other atherosclerotic consequences in the SCD. Key words: Sickle cell diseases, atherosclerosis, stroke, chronic obstructive pulmonary disease, digital clubbing, coronary heart disease, cirrhosis, chronic renal disease