Abstract

Cardiac complications are the most common cause of death in patients with thalassemia major. This study aims to assess cardiac complications in patients with thalassemia major in Iran.This study was conducted based on PRISMA guidelines for systematic review and meta-analysis studies. To find the relevant literature, a comprehensive search was conducted in several databases including SID, Magiran, Iranmedex, IranDoc, Medlib, PubMed, Scopus, Science Direct, Web of Science, and Google Scholar search engine. English and Persian MeSH keywords were searched without any time limited until 2017. Studies were selected according to the inclusion and exclusion criteria. To assess the heterogeneity between studies, I2 statistic and Cochran's Q test were used. Data were analyzed using Stata Ver.11.1 software through random effects model.In 20 studies, 3394 thalassemia major patients were surveyed. The mean age of the patients was 16.7. years. The prevalence of all types of cardiac complications in Iranian patients with thalassemia major was estimated to be 41.2 (95 CI: 25.3-57.2) and the prevalence for males and females patients was estimated to be 21.8 (95 CI: 9.3-34.4) and 21.4 (95 CI: 14.2-28.6), respectively. The most common echocardiographic abnormalities were diastolic dysfunction (40.2 95% CI: 14.1-66.2), systolic dysfunction (18.9% 95% CI: 9.4-28.5), pulmonary hypertension (14% 95% CI: 14.2-28.6), left ventricular hypertrophy (7.4% 95% CI: 2.5-12.3), tricuspid regurgitation (30.2% 95% CI: 11.2-50.4), mitral valve prolapse (16.4% 95% CI: 0-46.8), mitral regurgitation (12.3% 95% CI: 8.3-16.2) and aortic regurgitation (4.4% 95% CI: 0.2-8.9). The prevalence of abnormal echocardiography and electrocardiography was estimated to be 56.1% (95% CI: 9.0-100) and 32.6% (95% CI: 7.1-58.0), respectively. The relationship between cardiac complications and serum ferritin in patients with thalassemia major was not significant.The prevalence of cardiac complications in Iranian thalassemia major patients is high and screening the patients with thalassemia major in Iran for early diagnosis seems necessary. © 2017.