Cardiovascular risk assessment in haemophilia patients.
Haemophilia patients have a reduced cardiovascular mortality, which may be the result of a lifelong deficiency of factor VIII or IX. On the other hand, the prevalence of risk factors may differ in these chronically ill patients compared to the general population. The prevalence of risk factors and expected risk of cardiovascular disease was compared in haemophilia patients and healthy controls. In adult haemophilia A and B patients, body mass index, blood pressure, cholesterol levels and fasting glucose levels were measured and compared to healthy age-matched males. The expected risk of mortality due to cardiovascular disease was calculated using a European risk prediction algorithm (SCORE). A total of 100 haemophilia A and B patients and 200 healthy controls were analysed. The mean age of the patients was 47 years (range 18-83). The number of haemophiliacs with hyperglycaemia (24%) and hypertension (51%) was higher than in the controls (p-values 0.001 and 0.03, respectively). The mean low-density lipoprotein (LDL) cholesterol level in cases was lower than the controls (3.02 mM (0.69-6.57) and 3.60 mM (1.68-5.95), respectively, p < 0.001). Fewer cases had increased LDL levels (p=0.045). No difference was found in the 10-year cardiovascular mortality risk >10% between cases and controls (12% and 7%, respectively, p = 0.18). The prevalence of risk factors and expected risk of cardiovascular disease in haemophilia patients is comparable to the general population. This strengthens the hypothesis that hypocoagulability may reduce cardiovascular mortality in haemophilia patients.
Department of Vascular Medicine, F4-140 Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. s.rafi@amc.uva.nl
Sara
S
Biere-Rafi
Manuel A
MA
Baarslag
Marjolein
M
Peters
Marieke J H A
MJ
Kruip
Roderik A
RA
Kraaijenhagen
Martin
M
Den Heijer
Harry R
HR
Büller
Pieter W
PW
Kamphuisen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000401:mortality; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D048909:Diabetes Complications / Q000209:etiology / Q000401:mortality; D050171:Dyslipidemias / Q000150:complications / Q000401:mortality; D006467:Hemophilia A / Q000097:blood / Q000150:complications* / Q000401:mortality; D002836:Hemophilia B / Q000097:blood / Q000150:complications* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers