illustrate that development of cardiac disease in this cohort of transfused thalassemia patients could not have been predicted based upon serum ferritin values or liver iron concentrations while it may be generally true that the greater the total iron body load the greater the risk of developing iron induced cardiac disease no specific value of iron load was predictive of cardiac disease in those patients these data support a recent study in 58 transfusion dependent thalassemia patients where no correlation was observed between hepatic iron concentrations and cardiac function 19 the finding of this study is that patients maintained with the desferrioxamine treatment appear to be 4 fold more likely p 0 048 to develop a worsening of their cardiac status than those who were treated with deferiprone over the same period of time the difference does not appear to be related to a lack of compliance during the review period in the desferrioxamine treated group in fact only one of the ten desferrioxamine treated patients who presented a worsening of the heart function had a compliance rate lt 85 similarly many of these patients were u201c well chelated u201d based upon standard measures of total body iron illustrating that the cardio protective mechanism of deferiprone goes beyond simple chelation other factors.