title: Prevalence and risk factors of atherothrombotic events among 1054 hemophilia patients: a population-based analysis.
abstract: BACKGROUND
  Reports on the prevalence and risk factors of atherothrombotic events (AEs) are conflicting in persons with hemophilia (PWH).
  
  
  METHODS
  This study evaluated the prevalence and risk factors of AEs among 1054 male hemophilia patients, using data collected from Taiwan's National Health Insurance Research Database between 1997 and 2010, by comparing variable to those of an unaffected 10540 age- and gender-matched general population.
  
  
  RESULTS
  The proportions of all AEs among PWH, including 26 ischemic stroke, 29 coronary artery disease and 5 peripheral arterial disease were comparable to those in the general population. The mean age at diagnosis of AE among PWH was younger than that in the general population: 49.0 (95% CI, 43.6-54.5) and 55.8 years (95% CI, 54.5-57.0), P = 0.019, respectively. PWH with Chronic Obstructive Pulmonary Disease (COPD), hypertension, and hyperlipidemia were associated with greater risk for the occurrence of AEs, with hazard ratios (95% CI) of 3.42 (1.25-9.38), 4.15 (2.11-8.17), and 2.84 (1.39-5.79), respectively. PWH who needed replacement therapy had a lower risk of AEs than those who did not need, with a hazard ratio (95% CI) of 0.41 (0.21-0.81).
  
  
  CONCLUSIONS
  The study indicated the prevalence of AEs among PWH was comparable to that of the general population. AEs appeared at an earlier age among PWH. COPD, hypertension, and hyperlipidemia were risk factors for AEs. PWH who needed replacement therapy may have a lower risk of AEs.
authors.affiliation: Center of Rare Disease and Hemophilia, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jiaan-Der
authors.initials: JD
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan.
authors.forename: Wei-Cheng
authors.initials: WC
authors.lastname: Chan
authors.affiliation: Center of Rare Disease and Hemophilia, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yun-Ching
authors.initials: YC
authors.lastname: Fu
authors.affiliation: Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Kwok-Man
authors.initials: KM
authors.lastname: Tong
authors.affiliation: Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Shin-Tsu
authors.initials: ST
authors.lastname: Chang
authors.affiliation: Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Wen-Li
authors.initials: WL
authors.lastname: Hwang
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan.
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan. Electronic address: janyuhjer@gmail.com.
authors.forename: Yu-Tse
authors.initials: YT
authors.lastname: Tsan
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D006467:Hemophilia A / Q000150:complications* / Q000453:epidemiology; D002836:Hemophilia B / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: atherothrombosis; hemophilia; prevalence; risk factors