Prevention and treatment of atherosclerosis in haemophilia - how to balance risk of bleeding with risk of ischaemic events
(2015) In European Journal of Haematology 94. p.23-29- Abstract
- Life expectancy for patients with haemophilia (PWH) has significantly increased in the last decades, due to improvement of clotting factor replacement therapy. However, despite a lower cardiovascular mortality rate and contrasting prevalence for non-fatal ischaemic heart disease (IHD), cardiovascular diseases are increasing in PWH. The prevalence of cardiovascular risk factors in PWH is as prevalent as in the general population, whereas an increased risk of hypertension has been observed in some studies. Furthermore, PWH are not protected against atherosclerosis. Coronary artery disease treatment is extremely challenging in PWH. Two institutional' guidelines for the management of IHD in PWH have been published. Since these recommendations,... (More)
- Life expectancy for patients with haemophilia (PWH) has significantly increased in the last decades, due to improvement of clotting factor replacement therapy. However, despite a lower cardiovascular mortality rate and contrasting prevalence for non-fatal ischaemic heart disease (IHD), cardiovascular diseases are increasing in PWH. The prevalence of cardiovascular risk factors in PWH is as prevalent as in the general population, whereas an increased risk of hypertension has been observed in some studies. Furthermore, PWH are not protected against atherosclerosis. Coronary artery disease treatment is extremely challenging in PWH. Two institutional' guidelines for the management of IHD in PWH have been published. Since these recommendations, the use of new drugs such as prasugrel, ticagrelor, bivalirudin, new oral anticoagulants and new drug-eluting stents have been recommended in the general population but should be evaluated in PWH. Some questions arise: which trough level during long-term single or dual antiplatelet treatment (DAT) is really needed? The clinical role of platelet testing remains ill defined but may be considered in selected patients. A multidisciplinary approach is necessary for the management of IHD in PWH in order to treat the patient as any patient according to the cardiological guidelines during the acute phase, and long-term management should be discussed. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/5076000
- author
- de Raucourt, Emmanuelle ; Roussel-Robert, Valerie and Zetterberg, Eva LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- atherosclerosis, haemophilia, bleeding, coronary artery disease, hypertension
- in
- European Journal of Haematology
- volume
- 94
- pages
- 23 - 29
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000347371100006
- scopus:84920270558
- pmid:25560791
- ISSN
- 1600-0609
- DOI
- 10.1111/ejh.12498
- language
- English
- LU publication?
- yes
- id
- e7bfad41-abf3-43ca-ae06-62f62003a0ed (old id 5076000)
- date added to LUP
- 2016-04-01 10:26:00
- date last changed
- 2022-03-12 05:45:49
@article{e7bfad41-abf3-43ca-ae06-62f62003a0ed,
abstract = {{Life expectancy for patients with haemophilia (PWH) has significantly increased in the last decades, due to improvement of clotting factor replacement therapy. However, despite a lower cardiovascular mortality rate and contrasting prevalence for non-fatal ischaemic heart disease (IHD), cardiovascular diseases are increasing in PWH. The prevalence of cardiovascular risk factors in PWH is as prevalent as in the general population, whereas an increased risk of hypertension has been observed in some studies. Furthermore, PWH are not protected against atherosclerosis. Coronary artery disease treatment is extremely challenging in PWH. Two institutional' guidelines for the management of IHD in PWH have been published. Since these recommendations, the use of new drugs such as prasugrel, ticagrelor, bivalirudin, new oral anticoagulants and new drug-eluting stents have been recommended in the general population but should be evaluated in PWH. Some questions arise: which trough level during long-term single or dual antiplatelet treatment (DAT) is really needed? The clinical role of platelet testing remains ill defined but may be considered in selected patients. A multidisciplinary approach is necessary for the management of IHD in PWH in order to treat the patient as any patient according to the cardiological guidelines during the acute phase, and long-term management should be discussed.}},
author = {{de Raucourt, Emmanuelle and Roussel-Robert, Valerie and Zetterberg, Eva}},
issn = {{1600-0609}},
keywords = {{atherosclerosis; haemophilia; bleeding; coronary artery disease; hypertension}},
language = {{eng}},
pages = {{23--29}},
publisher = {{Wiley-Blackwell}},
series = {{European Journal of Haematology}},
title = {{Prevention and treatment of atherosclerosis in haemophilia - how to balance risk of bleeding with risk of ischaemic events}},
url = {{http://dx.doi.org/10.1111/ejh.12498}},
doi = {{10.1111/ejh.12498}},
volume = {{94}},
year = {{2015}},
}