title: Coronary artery calcification in hemophilia A: no evidence for a protective effect of factor VIII deficiency on atherosclerosis.
abstract: OBJECTIVE
  Ischemic heart disease mortality is lower in hemophilia patients than in the general male population. As coagulation plays a role in the inflammatory pathways involved in atherogenesis, we investigated whether the clotting factor deficiency protects hemophilia patients from developing atherosclerosis.
  
  
  RESULTS
  Coronary artery calcification, measured with multidetector-row computed tomography, was compared between 42 men, ≥59 years, with severe or moderate hemophilia A, and 613 nonhemophilic men from the Rotterdam Study, a prospective population-based study. None of the study subjects were HIV infected or had a history of cardiovascular disease. Coronary artery calcification was quantified by calculating the Agatston score and calcification mass. Data were analyzed using linear regression. Mean difference (β) of the natural log-transformed Agatston score between men with and without hemophilia was 0.141 (95% CI -0.602 to 0.885, P=0.709). Results did not change after adjustment for age, body mass index, hypercholesterolemia, hypertension, and use of antidiabetic medication (β=0.525, 95% CI -0.202 to 1.252, P=0.157). Comparable results were found for calcification mass.
  
  
  CONCLUSIONS
  The extent of coronary artery atherosclerosis is comparable between elderly men with and without hemophilia. Results from this study underline the importance of screening and treating atherosclerosis risk factors in hemophilia patients.
authors.affiliation: University Medical Center Utrecht, Van Creveldkliniek/Department of Hematology, Heidelberglaan 100, PO Box 85500, 3508 GA Utrecht, the Netherlands. a.tuinenburg-2@umcutrecht.nl
authors.forename: Attie
authors.initials: A
authors.lastname: Tuinenburg
authors.forename: Annemarieke
authors.initials: A
authors.lastname: Rutten
authors.forename: Maryam
authors.initials: M
authors.lastname: Kavousi
authors.forename: Frank W G
authors.initials: FW
authors.lastname: Leebeek
authors.forename: Paula F
authors.initials: PF
authors.lastname: Ypma
authors.forename: Britta A P
authors.initials: BA
authors.lastname: Laros-van Gorkom
authors.forename: Marten R
authors.initials: MR
authors.lastname: Nijziel
authors.forename: Pieter W
authors.initials: PW
authors.lastname: Kamphuisen
authors.forename: Eveline P
authors.initials: EP
authors.lastname: Mauser-Bunschoten
authors.forename: Goris
authors.initials: G
authors.lastname: Roosendaal
authors.forename: Douwe H
authors.initials: DH
authors.lastname: Biesma
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.forename: Roger E G
authors.initials: RE
authors.lastname: Schutgens
mesh_terms: D000367:Age Factors; D000368:Aged; D001777:Blood Coagulation / Q000235:genetics; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006467:Hemophilia A / Q000097:blood / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D061205:Vascular Calcification / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*