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Myocardial iron accumulation is a major cause of cardiomyopathy, heart failure, and death in patients with thalassemia major (TM). Chelation therapy can reduce the myocardial iron content and raise myocardial T2* scores in these patients, but only a third of those with severe iron overload benefit, even with a combination of chelating agents (NEJM JW Oncol Hematol July 2015, and Blood 2015; 125:3868). Amlodipine, a calcium channel blocking agent, has been shown to prevent iron uptake by cardiomyocytes.
To determine whether amlodipine would be a useful addition to chelation therapy in this setting, investigators conducted a multicenter, randomized, placebo-controlled, double-blind trial involving 62 patients with TM and a history of regular b…