title: Coronary atherosclerosis burden is not advanced in patients with β-thalassemia despite premature extracardiac atherosclerosis: a coronary artery calcium score and carotid intima-media thickness study.
abstract: BACKGROUND
  Thalassemic patients demonstrate an increased rate of extracardiac vascular complications and increased carotid wall intima-media thickness (cIMT), but very low prevalence of coronary artery disease (CAD). We investigated the atheroma burden by assessing the coronary artery calcium (CAC) and cIMT in these patients.
  
  
  METHODS
  We examined 37 patients with β-thalassemia and 150 healthy control volunteers with multi-detector computer tomography (CT) and ultrasonography to determine CAC score and cIMT, respectively.
  
  
  RESULTS
  Propensity score matching (C-statistic: 0.88; 95% CI: 0.83-0.93) resulted in 27 pairs of patients; severe CAC was observed in 2 (7.4%) and 0 of β-thalassemia patients and healthy volunteers respectively (P = 0.5). Median calcium score was 0 (0-0) in β-thalassemia patients and 0 (0-4) in healthy volunteers (P = 0.8). Median intima-media thickness was higher in β-thalassemia patients compared to control group [0.45 (0.06-0.65) vs. 0.062 (0.054-0.086); P = 0.04].
  
  
  CONCLUSIONS
  Patients with β-thalassemia in comparison with healthy control subjects exhibit similar CAC score and increased cIMT. Our findings indicate a disparate rate of progression of atherosclerosis between coronary and extracardiac arteries in these patients lending support to the epidemiological evidence.
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Hahalis
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Zacharioglou
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Xanthopoulou
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Koniari
authors.affiliation: Radiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Chistina
authors.initials: C
authors.lastname: Kalogeropoulou
authors.affiliation: Radiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Tsota
authors.affiliation: Radiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Aspasia
authors.initials: A
authors.lastname: Rigopoulou
authors.affiliation: Radiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Diamantopoulos
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Gkizas
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Periklis
authors.initials: P
authors.lastname: Davlouros
authors.affiliation: Internal Medicine Department of Patras University Hospital, Patras, Greece.
authors.forename: Karolina
authors.initials: K
authors.lastname: Akinosoglou
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Marianna
authors.initials: M
authors.lastname: Leopoulou
authors.affiliation: Internal Medicine Department of Patras University Hospital, Patras, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Gogos
authors.affiliation: Cardiology Department of Patras University Hospital, Patras, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Alexopoulos
keywords: Atherosclerosis; Calcium score; Carotid intima-media thickness; Coronary artery disease; Thalassemia