Τίτλος:
Stroke and presence of patent foramen ovale in sickle cell disease
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Sickle cell disease (SCD) is an inherited monogenic hemoglobinopathy characterized by formation of sickle erythrocytes under conditions of deoxygenation. Sickle erythrocytes can lead to thrombus formation and vaso-occlusive episodes that may result in hemolytic anemia, pain crisis and multiple organ damage. Moreover, SCD is characterized by endothelial damage, increased inflammatory response, platelet activation and aggravation, and activation of both the intrinsic and the extrinsic coagulation pathways. Cerebrovascular events constitute an important clinical complication of SCD. Children with SCD have a 300-fold higher risk of acute stroke and by the age of 45 about 25% of patients have suffered an overt stoke. Management and prevention of stroke in patients with SCD is not well defined. Moreover, the presence of patent foramen ovale (PFO) increases the risk of the occurrence of an embolic cerebrovascular event. The role of PFO closure and antiplatelet or anticoagulation therapy has not been well investigated. Moreover, during COVID-19 pandemic and taking into account the increased rates of thrombotic events and the difficulties in blood transfusion, management of SCD patients is even more challenging and difficult, since data are scarce regarding stroke occurrence and management in this specific population in the COVID-19 era. This review focuses on pathophysiology of stroke in patients with SCD and possible treatment strategies in the presence of PFO. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
Συγγραφείς:
Aggeli, C.
Polytarchou, K.
Dimitroglou, Y.
Patsourakos, D.
Delicou, S.
Vassilopoulou, S.
Tsiamis, E.
Tsioufis, K.
Περιοδικό:
Journal of Thrombosis and Thrombolysis
Λέξεις-κλειδιά:
antithrombocytic agent, cerebrovascular accident; coronavirus disease 2019; diagnostic test; endothelial dysfunction; human; patent foramen ovale; pathophysiology; primary prevention; Review; secondary prevention; sickle cell anemia; cerebrovascular accident; complication; patent foramen ovale; prognosis; recurrent disease; risk assessment; risk factor; sickle cell anemia, Anemia, Sickle Cell; COVID-19; Foramen Ovale, Patent; Humans; Primary Prevention; Prognosis; Recurrence; Risk Assessment; Risk Factors; Secondary Prevention; Stroke
DOI:
10.1007/s11239-021-02398-3
