Serum cardiac troponin I and alpha fetoprotein levels in adults with sickle cell anaemia in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria

Background: Several cardiac and hepatic abnormalities have been observed in patients with sickle cell anemia (SCA) which significantly increase disease-related morbidity and mortality. Objective: To determine the levels of cardiac troponin 1 (cTnI) and alpha-fetoprotein (AFP) in adults with SCA and compare with suitable controls. Subjects and Methods: A total of 95 participants, consisting of 30 heterozygous hemoglobin AS (HbAS), 30 homozygous hemoglobin SS (HbSS) (in steady state), 5 HbSS (in crisis), and 30 hemoglobin AA (HbAA), were studied. Five milliliter of venous blood was collected from each participant for cTnI and AFP level estimation (by the enzyme-linked immunosorbent assay technique) and hemoglobin phenotype confirmation (by cellulose acetate electrophoresis). Results: The mean serum level of cTnI was significantly higher in homozygous SCA participants in crisis compared HbAA controls and SCA participants in steady state (1.13 ± 0.46 ng/ml vs. 0.32 ± 0.03 ng/ml and 1.13 ± 0.46 ng/ml vs. 0.27 ± 0.04 ng/ml, respectively, P = 0.01). There were no significant differences in the mean serum levels of cTnI between SCA participant in steady state and HbAS and HbAA ( P = 0.33 and 0.58, respectively). Serum AFP levels were not significantly different in SCA (both in crises and in steady state) compared with HbAS and HbAA participants ( P values all > 0.05). Conclusion: Cardiac injury may underlie SCA bone pain crisis; assessment of cardiac function may be indicated, particularly in patients with recurrent crises.