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Can STOP Trial Velocity Criteria Be Applied to Iranian Children with Sickle Cell Disease?

Reza Bavarsad Shahripour1, Martin M Mortazavi2, Kristian Barlinn3

  • 1Department of Neurology, Ahvaz University of Medical Sciences, Ahvaz, Khuzestan, Iran. ; Comprehensive Stroke Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.

Journal of Stroke
|June 21, 2014
PubMed

Insights

Transcranial Doppler (TCD) ultrasound reveals elevated blood flow velocities in Iranian children with sickle cell disease (SCD). These findings suggest ethnicity-specific criteria may be needed to identify stroke risk in this population.

Area of Science:

  • Pediatric Neurology
  • Vascular Ultrasound
  • Hematology

Background:

  • Sickle cell disease (SCD) is a significant risk factor for stroke in children.
  • Transcranial Doppler (TCD) ultrasound is used to assess stroke risk in SCD patients, particularly in African-Americans.
  • The applicability of established TCD velocity cut-offs to other ethnic groups, such as Iranian children, is not well-defined.

Purpose of the Study:

  • To evaluate baseline Transcranial Doppler (TCD) findings in Iranian children diagnosed with sickle cell disease (SCD).
  • To compare TCD-derived blood flow velocities between Iranian children with SCD and healthy controls.
  • To investigate potential differences in TCD velocity thresholds for stroke risk assessment in Iranian children with SCD.

Main Methods:

  • Prospective recruitment of Iranian children with genetically confirmed SCD and age-matched healthy controls.
  • Performance of TCD ultrasound to measure Time Averaged Maximum Mean (TAMM) velocities in the middle cerebral arteries (MCA) and terminal internal carotid arteries (TICA).
  • Statistical analysis to compare TCD velocity parameters between SCD patients and controls.

Main Results:

  • Sixty children (62% female, mean age 10 years) met inclusion criteria.
  • Children with SCD exhibited significantly higher right MCA TAMM velocities compared to controls (125±5.52 cm/s vs. 92.5±1.63 cm/s).
  • Terminal internal carotid artery (TICA) TAMM velocities also showed significant differences between SCD patients and controls.

Conclusions:

  • Iranian children with asymptomatic SCD have higher TCD velocities than healthy controls.
  • Observed velocities are lower than those reported in previous international stroke prevention trials.
  • Ethnicity-specific prognostic criteria for TCD-based stroke risk assessment in Iranian children with SCD are warranted.
Abstract

Keywords:
STOP criteriaSickle cellTCD

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