A cross-sectional analysis of cardiovascular disease in the hemophilia population

Area of Science:

• Cardiovascular Medicine
• Hematology
• Epidemiology

Background:

• Historically, men with hemophilia were considered protected from cardiovascular disease (CVD).
• Emerging evidence indicates that atherothrombotic events do occur in this population.
• Understanding CVD prevalence and risk factors in hemophilia is critical for patient care.

Purpose of the Study:

• To determine the prevalence of CVD and associated risk factors in US older men with moderate to severe hemophilia.
• To compare CVD rates in hemophilia patients with age-comparable men from the Atherosclerosis Risk in Communities (ARIC) cohort.
• To test the hypothesis that lower factor levels might be protective against CVD.

Main Methods:

• The CVD in Hemophilia study enrolled 200 men aged 54-73 with hemophilia A or B (factor levels ≤ 5%) from 19 US centers.
• Data collection included patient interviews, medical records, fasting blood samples, and electrocardiograms (ECGs).
• CVD was defined by specific clinical events including angina, myocardial infarction, stroke, transient ischemic attack, and revascularization procedures.

Main Results:

• CVD risk factors were prevalent among the study participants.
• Men with hemophilia showed significantly lower CVD prevalence (15%) compared to age-matched men in the ARIC cohort (25.8%; P < .001).
• Despite lower overall rates, individual CVD events occurred, highlighting the need for preventive strategies.

Conclusions:

• While hemophilia patients exhibit lower CVD rates than the general population, cardiovascular events still occur.
• Preventive measures for cardiovascular events are warranted in men with hemophilia.
• Few patients were receiving secondary prophylaxis with low-dose aspirin, indicating a potential gap in care despite its established safety.