Patient demographics, outcome and process metrics
| Preintervention | Postintervention | P 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, %) | 100 | 58 | – |
| Normal | 74 (74) | 56 (96.5) | 0.04 |
| Abnormal | 26 (26) | 2 (3.5) | |
| Systolic dysfunction only (on conventional and/or strain imaging) | 15 (57.7) | 1 (50) | – |
| Diastolic dysfunction only | 6 (23.1) | 1 (50) | |
| Systolic and diastolic dysfunction both | 3 (11.5) | 0 | |
| Pulmonary artery hypertension | 2 (7.7) | 0 | |
| Holter (n, %) | 45 | 1 | – |
| Normal | 17 (38) | 0 | |
| Abnormal | 28 (62) | 1 (100) | |
| Atrial arrhythmias/tachycardia | 18 (64) | 1 (100) | |
| Sustained or non-sustained ectopic atrial tachycardia | 7 (39) | 1 (100) | |
| Atrial flutter | 1 (5.5) | – | |
| Premature atrial beats | 10 (55.5) | – | |
| Ventricular arrhythmias/tachycardia | 4 (14) | – | |
| Ventricular ectopy | 3 (75) | – | |
| Non-sustained ventricular tachycardia | 1 (25) | – | |
| Conduction defects | 4 (14) | – | |
| First degree atrioventricular block | 3 (75) | – | |
| Right bundle branch block | 1 (25) | – | |
| Sinus tachycardia | 3 (10.7) | – | |
| Ectopic at pace low sinus rhythm | 9 (32) | – | |
| Outcome metric | |||
| T2*CMR value | 100 | 55 | |
| <10 ms | 51 (51) | 30 (55) | |
| 10–15 ms | 17 (17) | 11 (20) | |
| 15–20 ms | 5 (5) | 3 (5) | |
| >20 ms | 27 (27) | 11 (20) | |
| Percentage of patients with postintervention increase or unchanged T2*CMR value | 82 (82%) | ||
| Percentage of patients with postintervention decrease in T2*CMR value | 18 (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 compliance | 11 (11) | 86 (86)† | |
| Partial compliance | 50 (50) | 13 (13)† | 0.0001 |
| No compliance | 39 (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.