Table 3

Patient demographics, outcome and process metrics

PreinterventionPostinterventionP value
Baseline data
Median serum ferritin (min–max, ng/mL)4808 (364–39 500)4340 (252–11 000)0.004
Median T2*CMR value (min–max; ms)9.3 (1.7–49)10.1 (2.1–45.8)0.29
Echocardiography (n, %)10058
 Normal74 (74)56 (96.5)0.04
 Abnormal26 (26)2 (3.5)
 Systolic dysfunction only (on conventional and/or strain imaging)15 (57.7)1 (50)
 Diastolic dysfunction only6 (23.1)1 (50)
 Systolic and diastolic dysfunction both3 (11.5)0
 Pulmonary artery hypertension2 (7.7)0
Holter (n, %)451
Normal17 (38)0
Abnormal28 (62)1 (100)
Atrial arrhythmias/tachycardia18 (64)1 (100)
 Sustained or non-sustained ectopic atrial tachycardia7 (39)1 (100)
 Atrial flutter1 (5.5)
 Premature atrial beats10 (55.5)
Ventricular arrhythmias/tachycardia4 (14)
 Ventricular ectopy3 (75)
 Non-sustained ventricular tachycardia1 (25)
Conduction defects4 (14)
 First degree atrioventricular block3 (75)
 Right bundle branch block1 (25)
Sinus tachycardia3 (10.7)
Ectopic at pace low sinus rhythm9 (32)
Outcome metric
T2*CMR value10055
 <10 ms51 (51)30 (55)
 10–15 ms17 (17)11 (20)
 15–20 ms5 (5)3 (5)
 >20 ms27 (27)11 (20)
Percentage of patients with postintervention increase or unchanged T2*CMR value82 (82%)
Percentage of patients with postintervention decrease in T2*CMR value18 (18%)
Process metric
Cardiac assessment according to guidelines (n,%)0 (0)100 (100)
Follow-up for cardiac assessment according to guidelines (n,%)0 (0)55 (55)
Standardisation of chelation therapy according to T2*CMR (n, %)*5 (5)100 (100)0.0001
Compliance with chelation therapy (n,%)
 Optimal compliance11 (11)86 (86)†
 Partial compliance50 (50)13 (13)†0.0001
 No compliance39 (39)1 (1)
AE reporting of chelation therapy (n, %)0 (0)100 (100)
  • *Chelation was intensified in 89% (n=89), reduced in 6% (n=6) and remained unchanged in 5% (n=5) patients after baseline T2*CMR. Cardiac doses were prescribed in 66% and in-hospital emergent chelation was indicated in 30% of patients.

  • †Reasons for partial or non-compliance include non-affordability (n=4, 29%), personal reasons (n=2, 14%) and infusion related class 3 AEs secondary to DFO (n=8, 57%).

  • AE, adverse events; DFO, deferoxamine; max, maximum; min, minimum; T2*CMR, cardiac T2* magnetic resonance imaging.