Cardiovascular risk markers lose reliability as iron overload progresses in transfusion-dependent thalassemia

Patients with transfusion-dependent thalassemia (TDT) face significant cardiovascular risks, but as iron overload progresses and diminishes the effectiveness of risk markers, comprehensive monitoring and personalized management become essential, according to a study.

The cross-sectional study analyzed 32 patients with TDT and 36 healthy controls, matched by age and gender. Researchers examined a range of health parameters and 2 novel markers—Plasma Atherogenic Index (PAI) and the Triglyceride-Glucose (TyG) index—were used to evaluate cardiovascular risks.

Patients with TDT were found to have significantly lower hemoglobin levels, higher platelet counts, and elevated liver enzymes compared to controls. Lipid profiles showed lower levels of total cholesterol, HDL, and LDL, but higher triglycerides. The PAI was significantly elevated in patients with TDT, suggesting increased atherosclerotic risk.

Subgroup analysis found that patients with cardiac involvement had worse metabolic profiles, higher TyG indices, and prolonged QT intervals, reflecting heightened cardiovascular risks. However, the study found that as iron burden increases, the utility of PAI and TyG markers diminishes.

Reference

Yalcin N, Sadri S, Ertınmaz Özkan A, et al. Elevated Plasma Atherogenic and Triglyceride-Glucose Indices: Markers of Cardiovascular Risk in Transfusion-Dependent Thalassemia. Hemoglobin. 2024 Oct 15:1-9. doi: 10.1080/03630269.2024.2412111. Epub ahead of print. PMID: 39410756.