Pes GM, et al. - In this retrospective observational case-control study, researchers investigated whether glucose-6-phosphate dehydrogenase (G6PD) deficiency, a genetically inherited condition causing hemolytic anemia, confers risk for cardiovascular disease (CVD). This study was conducted with 9,604 patients from Northern Sardinia undergoing digestive endoscopy between 2002 and 2017 with a known G6PD status. Clinical records of these patients and their complete clinical history including CVD and leading CVD risk factors were analyzed. A 1:2 propensity score-matched analysis was also carried out to circumvent covariates imbalance between cases and controls, resulting in 1,123 G6PD deficient patients and 2,246 patients with normal enzyme activity. Age, male sex, high blood pressure, smoking, diabetes, and hypercholesterolemia were documented as the major predictive factors for CVD. Findings revealed a significant association between G6PD deficiency and increased risk of CVD. A possible critical role was suggested for the loss of vital protective pathways against oxidative stress, particularly in the early stages of atherogenesis.