1
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Camelo RM, Caram-Deelder C, Duarte BP, de Moura MCB, Costa NCDM, Costa IM, Vanderlei AM, Guimarães TMR, Gouw S, Rezende SM, van der Bom J. Cardiovascular Risk Scores among Asymptomatic Adults with Haemophilia. Arq Bras Cardiol 2023; 120:e20230004. [PMID: 37729292 PMCID: PMC10519352 DOI: 10.36660/abc.20230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/12/2023] [Accepted: 07/17/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The mortality rate of Brazilian people with haemophilia (PwH) is decreasing, but the relative incidence of deaths associated with cardiovascular disease (CVD) is increasing. OBJECTIVES We aimed to describe the CVD risk score of PwH according to Pooled Cohort Equations Risk (PCER) Calculator tool and its treatment recommendations. We also compared the PCER estimates with the respective Framingham Risk Score (FRS). METHODS This cross-sectional study included male PwH ≥ 40 years treated at the Comprehensive Haemophilia Treatment Centre of Pernambuco (Recife/Brazil). PwH with a previous CVD event or a low-density lipid cholesterol ≥ 5.0 mmol/L were excluded. Interviews, medical file reviews, and blood tests were performed. The PCER tool was used to estimate the CVD risk and compare it with the respective FRS. A p-value < 0.05 was accepted as statistically significant. RESULTS Thirty PwH were included. Median age was 51.5 [interquartile range-IQR; 46.0-59.5] years. The prevalence of obesity, systemic arterial hypertension, diabetes mellitus, hypertriglyceridaemia, hypercholesterolaemia, and hypoHDLaemia were 20%, 67%, 24%, 14%, 47%, and 23%, respectively. The median PCER score was 6.9% [IQR; 3.1-13.2], with 50% having a high risk (PCER ≥ 7.5%). Statin use was suggested for 54% of PwH. Blood pressure was poorly controlled in 47% of PwH. The agreement between PCER and FRS was 80% (κ = 0.60; p = 0.001). CONCLUSIONS Half of the male people with haemophilia aged 40 years or older had a 10-year high risk of developing CVD with strong recommendations to improve control of dyslipidaemia and blood pressure.
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Affiliation(s)
- Ricardo Mesquita Camelo
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasilFaculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG – Brasil
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
| | - Camila Caram-Deelder
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
- SanquinLUMCLeidenPaíses BaixosJon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden – Países Baixos
| | - Bruna Pontes Duarte
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
| | | | | | - Iris Maciel Costa
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
| | - Ana Maria Vanderlei
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
| | - Tania Maria Rocha Guimarães
- HEMOPERecifePEBrasilFundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE – Brasil
- Faculdade de Enfermagem Nossa Senhora das GraçasUniversidade de PernambucoRecifePEBrasilFaculdade de Enfermagem Nossa Senhora das Graças, Universidade de Pernambuco, Recife, PE – Brasil
| | - Samantha Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
- Department of Pediatric HematologyEmma Children’s HospitalUniversity of AmsterdamAmsterdãPaíses BaixosDepartment of Pediatric Hematology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam,Amsterdã – Países Baixos
| | - Suely Meireles Rezende
- Faculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasilFaculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG – Brasil
| | - Johanna van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenPaíses BaixosDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden – Países Baixos
- SanquinLUMCLeidenPaíses BaixosJon J van Rood Center for Clinical Transfusion Research, Sanquin/LUMC, Leiden – Países Baixos
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2
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Nagao A, Ioka A, Nakamura T, Murakami Y, Makishima M, Okada N, Sakai M. Burden of congenital hemophilia A requiring treatment in Japan: The HIKOBOSHI study. Res Pract Thromb Haemost 2022; 6:e12825. [PMID: 36320425 PMCID: PMC9615292 DOI: 10.1002/rth2.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/30/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background Treatment of congenital hemophilia A (HA) in Japan has greatly improved with the widespread adoption of prophylactic factor (F)VIII concentrates. However, it is unknown if this has translated into a real‐world reduction in disease and treatment burden. Objectives To describe HA disease burden in Japan based on information from two medical information databases, JMDC and Real World Data Co., Ltd. (RWD). Methods Eligible individuals were diagnosed with congenital HA and prescribed FVIII concentrates, bypassing agents, or emicizumab. Treatment patterns and disease burden data were derived from health insurance claims and electronic medical records. Results Data on 459 people with HA were retrospectively collected from 2005 to 2020 in the JMDC database (median [min, max] of 37 [2, 186] months of available records), and 229 people with HA from 1985 to 2020 in the RWD database (median [min, max] of 154 [0, 409] months of available records). Mean (standard deviation) ages at the time of the first record were 25.0 (16.8) years (JMDC) and 19.2 (20.3) years (RWD). In the JMDC database, mean monthly FVIII dose increased from 2201 IU in 2005 to 8239 IU in 2013 to 11,377 IU in 2019; HA‐related drug costs increased accordingly. Mean (95% confidence interval) annual outpatient and out‐of‐hours visits decreased slightly between 2013 and 2019 (outpatient visits: from 22.9 [16.8–29.0] to 14.3 [12.6–16.1] per person; out‐of‐hours visits: from 1.3 [0.2–2.5] to 0.6 [0–1.4]). There was no change in mean number of hospitalizations. Conclusions Challenges remain in HA, including treatment burden, outpatient visits, and hospitalizations.
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Affiliation(s)
| | - Akiko Ioka
- Chugai Pharmaceutical Co., Ltd.TokyoJapan
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3
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Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, Cuisset T, Cutlip D, Eerdmans P, Eikelboom J, Farb A, Gibson CM, Gregson J, Haude M, James SK, Kim HS, Kimura T, Konishi A, Laschinger J, Leon MB, Magee PFA, Mitsutake Y, Mylotte D, Pocock S, Price MJ, Rao SV, Spitzer E, Stockbridge N, Valgimigli M, Varenne O, Windhoevel U, Yeh RW, Krucoff MW, Morice MC. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk. Eur Heart J 2019; 40:2632-2653. [PMID: 31116395 PMCID: PMC6736433 DOI: 10.1093/eurheartj/ehz372] [Citation(s) in RCA: 316] [Impact Index Per Article: 63.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Identification and management of patients at high bleeding risk undergoing percutaneous coronary intervention are of major importance, but a lack of standardization in defining this population limits trial design, data interpretation, and clinical decision-making. The Academic Research Consortium for High Bleeding Risk (ARC-HBR) is a collaboration among leading research organizations, regulatory authorities, and physician-scientists from the United States, Asia, and Europe focusing on percutaneous coronary intervention-related bleeding. Two meetings of the 31-member consortium were held in Washington, DC, in April 2018 and in Paris, France, in October 2018. These meetings were organized by the Cardiovascular European Research Center on behalf of the ARC-HBR group and included representatives of the US Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, as well as observers from the pharmaceutical and medical device industries. A consensus definition of patients at high bleeding risk was developed that was based on review of the available evidence. The definition is intended to provide consistency in defining this population for clinical trials and to complement clinical decision-making and regulatory review. The proposed ARC-HBR consensus document represents the first pragmatic approach to a consistent definition of high bleeding risk in clinical trials evaluating the safety and effectiveness of devices and drug regimens for patients undergoing percutaneous coronary intervention.
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Affiliation(s)
- Philip Urban
- La Tour Hospital, Geneva, Switzerland
- Cardiovascular European Research Center, Massy, France
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - Roisin Colleran
- Deutsches Herzzentrum München, Technische Universität München,
Germany
| | | | - Robert A Byrne
- Deutsches Herzzentrum München, Technische Universität München,
Germany
| | - Davide Capodanno
- Cardio-Thoracic-Vascular Department, Centro Alte Specialità e Trapianti,
Catania, Italy
- Azienda Ospedaliero Universitario “Vittorio Emanuele-Policlinico,”
University of Catania, Italy
| | - Thomas Cuisset
- Département de Cardiologie, Centre Hospitalier Universitaire Timone and
Inserm, Inra, Centre de recherche en cardiovasculaire et nutrition, Faculté de Médecine,
Aix-Marseille Université, Marseille, France
| | - Donald Cutlip
- Cardiology Division, Beth Israel Deaconess Medical Center, Harvard
Medical School, Boston, MA
| | | | - John Eikelboom
- Department of Medicine, McMaster University, Hamilton, Canada
| | - Andrew Farb
- US Food and Drug Administration, Silver Spring, MD
| | - C Michael Gibson
- Harvard Medical School, Boston, MA
- Baim Institute for Clinical Research, Brookline, MA
| | - John Gregson
- London School of Hygiene and Tropical Medicine, UK
| | - Michael Haude
- Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Germany
| | - Stefan K James
- Department of Medical Sciences and Uppsala Clinical Research Center,
Uppsala University, Sweden
| | - Hyo-Soo Kim
- Cardiovascular Center, Seoul National University Hospital, Korea
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School
of Medicine, Japan
| | - Akihide Konishi
- Office of Medical Devices 1, Pharmaceuticals and Medical Devices
Agency, Tokyo, Japan
| | | | - Martin B Leon
- Columbia University Medical Center, New York, NY
- Cardiovascular Research Foundation, New York, NY
| | | | - Yoshiaki Mitsutake
- Office of Medical Devices 1, Pharmaceuticals and Medical Devices
Agency, Tokyo, Japan
| | - Darren Mylotte
- University Hospital and National University of Ireland, Galway
| | | | | | - Sunil V Rao
- Duke Clinical Research Institute, Durham, NC
| | - Ernest Spitzer
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the
Netherlands
- Cardialysis, Clinical Trial Management and Core Laboratories,
Rotterdam, the Netherlands
| | | | - Marco Valgimigli
- Department of Cardiology, Inselspital, University of Bern,
Switzerland
| | - Olivier Varenne
- Service de Cardiologie, Hôpital Cochin, Assistance publique - hôpitaux
de Paris, Paris, France
- Université Paris Descartes, Sorbonne Paris-Cité, France
| | | | - Robert W Yeh
- Beth Israel Deaconess Medical Center, Boston, MA
| | - Mitchell W Krucoff
- Duke Clinical Research Institute, Durham, NC
- Duke University Medical Center, Durham, NC
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4
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Urban P, Mehran R, Colleran R, Angiolillo DJ, Byrne RA, Capodanno D, Cuisset T, Cutlip D, Eerdmans P, Eikelboom J, Farb A, Gibson CM, Gregson J, Haude M, James SK, Kim HS, Kimura T, Konishi A, Laschinger J, Leon MB, Magee PA, Mitsutake Y, Mylotte D, Pocock S, Price MJ, Rao SV, Spitzer E, Stockbridge N, Valgimigli M, Varenne O, Windhoevel U, Yeh RW, Krucoff MW, Morice MC. Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention. Circulation 2019; 140:240-261. [PMID: 31116032 PMCID: PMC6636810 DOI: 10.1161/circulationaha.119.040167] [Citation(s) in RCA: 417] [Impact Index Per Article: 83.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Identification and management of patients at high bleeding risk undergoing percutaneous coronary intervention are of major importance, but a lack of standardization in defining this population limits trial design, data interpretation, and clinical decision-making. The Academic Research Consortium for High Bleeding Risk (ARC-HBR) is a collaboration among leading research organizations, regulatory authorities, and physician-scientists from the United States, Asia, and Europe focusing on percutaneous coronary intervention-related bleeding. Two meetings of the 31-member consortium were held in Washington, DC, in April 2018 and in Paris, France, in October 2018. These meetings were organized by the Cardiovascular European Research Center on behalf of the ARC-HBR group and included representatives of the US Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, as well as observers from the pharmaceutical and medical device industries. A consensus definition of patients at high bleeding risk was developed that was based on review of the available evidence. The definition is intended to provide consistency in defining this population for clinical trials and to complement clinical decision-making and regulatory review. The proposed ARC-HBR consensus document represents the first pragmatic approach to a consistent definition of high bleeding risk in clinical trials evaluating the safety and effectiveness of devices and drug regimens for patients undergoing percutaneous coronary intervention.
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Affiliation(s)
- Philip Urban
- La Tour Hospital, Geneva, Switzerland (P.U.)
- Cardiovascular European Research Center, Massy, France (P.U., U.W., M.-C.M.)
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, New York, NY (R.M.)
| | - Roisin Colleran
- Deutsches Herzzentrum München, Technische Universität München, Germany (R.C., R.A.B.)
| | - Dominick J. Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville (D.J.A.)
| | - Robert A. Byrne
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (R.A.B.)
| | - Davide Capodanno
- Cardio-Thoracic-Vascular Department, Centro Alte Specialità e Trapianti (D. Capodanno), Catania, Italy
- Azienda Ospedaliero Universitario “Vittorio Emanuele-Policlinico,” University of Catania, Italy (D. Capodanno)
| | - Thomas Cuisset
- Département de Cardiologie, Centre Hospitalier Universitaire Timone and Inserm, Inra, Centre de recherche en cardiovasculaire et nutrition, Faculté de Médecine, Aix-Marseille Université, Marseille, France (T.C.)
| | - Donald Cutlip
- Cardiology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D. Cutlip)
| | - Pedro Eerdmans
- Head of the Notified Body, DEKRA Certification B.V. (P.E.)
| | - John Eikelboom
- Department of Medicine, McMaster University, Hamilton, Canada (J.E.)
| | - Andrew Farb
- US Food and Drug Administration, Silver Spring, MD (A.F., J.L., P.F.A.M., N.S.)
| | - C. Michael Gibson
- Baim Institute for Clinical Research, Brookline, MA (C.M.G.)
- Harvard Medical School, Boston, MA (C.M.G.)
| | - John Gregson
- London School of Hygiene and Tropical Medicine, UK (J.G., S.P.)
| | - Michael Haude
- Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Germany (M.H.)
| | - Stefan K. James
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (S.K.J.)
| | - Hyo-Soo Kim
- Cardiovascular Center, Seoul National University Hospital, Korea (H.-S.K.)
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan (T.K.)
| | - Akihide Konishi
- Office of Medical Devices 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan (A.K., Y.M.)
| | - John Laschinger
- US Food and Drug Administration, Silver Spring, MD (A.F., J.L., P.F.A.M., N.S.)
| | - Martin B. Leon
- Columbia University Medical Center, New York, NY (M.B.L.)
- Cardiovascular Research Foundation, New York, NY (M.B.L.)
| | - P.F. Adrian Magee
- US Food and Drug Administration, Silver Spring, MD (A.F., J.L., P.F.A.M., N.S.)
| | - Yoshiaki Mitsutake
- Office of Medical Devices 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan (A.K., Y.M.)
| | - Darren Mylotte
- University Hospital and National University of Ireland, Galway (D.M.)
| | - Stuart Pocock
- London School of Hygiene and Tropical Medicine, UK (J.G., S.P.)
| | | | - Sunil V. Rao
- Duke Clinical Research Institute, Durham, NC (S.V.R., M.W.K.)
| | - Ernest Spitzer
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands (E.S.)
- Cardialysis, Clinical Trial Management and Core Laboratories, Rotterdam, the Netherlands (E.S.)
| | - Norman Stockbridge
- US Food and Drug Administration, Silver Spring, MD (A.F., J.L., P.F.A.M., N.S.)
| | - Marco Valgimigli
- Department of Cardiology, Inselspital, University of Bern, Switzerland (M.V.)
| | - Olivier Varenne
- Service de Cardiologie, Hôpital Cochin, Assistance publique - hôpitaux de Paris, Paris, France (O.V.)
- Université Paris Descartes, Sorbonne Paris-Cité, France (O.V.)
| | - Ute Windhoevel
- Cardiovascular European Research Center, Massy, France (P.U., U.W., M.-C.M.)
| | - Robert W. Yeh
- Beth Israel Deaconess Medical Center, Boston, MA (R.W.Y.)
| | - Mitchell W. Krucoff
- Duke Clinical Research Institute, Durham, NC (S.V.R., M.W.K.)
- Duke University Medical Center, Durham, NC (M.W.K.)
| | - Marie-Claude Morice
- Cardiovascular European Research Center, Massy, France (P.U., U.W., M.-C.M.)
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5
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Abstract
Advances in the development of effective and safe treatments for haemophilia over the last 50 years have resulted in a significant increase in the life expectancy of persons with haemophilia (PWH). The management of this new cohort of middle-aged and elderly PWH is challenging because of the opposing risks of haemophilia and age-related cardiovascular disease and malignancy. Furthermore, this cohort of ageing PWH has the additional comorbidities of human immunodeficiency virus/hepatitis C and chronic haemophilic arthropathy. This article reviews the prevalence, underlying mechanisms and treatment strategies for managing these comorbidities. International collaboration is essential for registry data and further prospective trials to inform optimal evidence-based management for this rare disorder in the future.
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Affiliation(s)
- Susan Shapiro
- Oxford Haemophilia and Thrombosis Centre, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Mike Makris
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.,Sheffield Haemophilia and Thrombosis Centre, Royal Hallamshire Hospital, Sheffield, UK
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6
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Jabbar AY, Baydoun H, Janbain M, Ferdinand KC. Current concepts in the management of stable ischemic heart disease and acute coronary syndrome in patients with hemophilia. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:299. [PMID: 30211187 DOI: 10.21037/atm.2018.05.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Coronary artery disease (CAD), including stable ischemic heart disease (SIHD) and acute coronary syndrome (ACS), remains the leading cause of death in the US and one of the primary modalities used in the treatment of CAD is percutaneous coronary intervention (PCI). Despite the potential benefits of PCI in high risk CAD patients, the risk of hemorrhage presents a dilemma in the treatment of patients with hemophilia A and B. In an attempt to provide guidance on the management of SIHD and ACS in patients with hemophilia, we present the case of a patient with moderate hemophilia B and ACS who subsequently underwent PCI followed by a review of the associated literature.
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Affiliation(s)
- Ahmad Y Jabbar
- Department of Medicine, Tulane School of Medicine, Tulane Heart and Vascular Institute, New Orleans, LA, USA
| | - Hassan Baydoun
- Department of Medicine, Tulane School of Medicine, Tulane Heart and Vascular Institute, New Orleans, LA, USA
| | - Maissaa Janbain
- Department of Medicine, Tulane School of Medicine, Tulane Heart and Vascular Institute, New Orleans, LA, USA
| | - Keith C Ferdinand
- Department of Medicine, Tulane School of Medicine, Tulane Heart and Vascular Institute, New Orleans, LA, USA
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7
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Kanellopoulou T, Nomikou E. Replacement therapy for coronary artery bypass surgery in patients with hemophilia A and B. J Card Surg 2018; 33:76-82. [DOI: 10.1111/jocs.13530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Theoni Kanellopoulou
- Department of Clinical Hematology-Blood Bank and Hemostasis; Onassis Cardiac Surgery Center; Kallithea Greece
| | - Efrosyni Nomikou
- Blood Bank and Hemophilia Unit; Hippokration General Hospital of Athens; Athens Greece
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8
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Berntorp E, Mauser-Bunschoten E, Jiménez-Yuste V, Spears JB. Comorbidities and inhibitors in adult patients with haemophilia: issues, costs and management strategies. Eur J Haematol 2016; 95 Suppl 80:1-15. [PMID: 26492487 DOI: 10.1111/ejh.12681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 01/19/2023]
Abstract
Along with greater life expectancy in patients with haemophilia has been an increase in associated haemophilia-related (arthropathy, osteoporosis, viral infections) and age-related (cardiovascular disease, renal disease, cancer and others) comorbidities, many of which are only just emerging as the population ages. At present, experience in managing these comorbidities is limited. As the demographic shift continues, haemophilia care centres can expect to encounter more patients with greater levels of complexity. In the absence of evidence-based information to guide the management of adult patients with haemophilia, it is important that the scientific position be reviewed on a regular basis. To this end, several topics relevant to the clinical management of adult patients with haemophilia were examined in a symposium entitled Comorbidities and inhibitors in adult patients with haemophilia: issues, costs and management strategies held on 11 February 2015 in Helsinki, Finland, in conjunction with the 8th Annual Congress of the European Association for Haemophilia and Allied Disorders. This article is a summary of that event.
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Affiliation(s)
- Erik Berntorp
- Clinical Coagulation Research Unit, Skåne University Hospital, Malmö, Sweden
| | - Evelien Mauser-Bunschoten
- Van Creveldkliniek, Department of Benign Haematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Víctor Jiménez-Yuste
- La Paz University Hospital, Coagulopathy Unit, Haematology Service, Madrid, Spain
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9
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Neufeld EJ, Négrier C, Arkhammar P, el Fegoun SB, Simonsen MD, Rosholm A, Seremetis S. Safety update on the use of recombinant activated factor VII in approved indications. Blood Rev 2015; 29 Suppl 1:S34-41. [PMID: 26073367 DOI: 10.1016/s0268-960x(15)30006-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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