0350: Prevalence and management of cardiovascular diseases in patients with hemophilia

Abstract

The emergence of new herapies based on enhanced prevention and treatment of viral diseases led to a significant improvement in hemophiliacs’ life expectancy. Consequently, they are currently exposed to cardiovascular diseases and candidates for antithrombotic treatments. The benefits of antithrombotic therapy have not been demonstrated for this population and abnormal blood crasis may also provide a degree of antithrombotic protection. In this study, we aim to assess the prevalence of cardiovascular disease and cardiovascular risk factors in patients with hemophilia, but also collect data concerning the management of these diseases. This study prospective, observational and monocentric was conducted in a cohort of patients over 50 year old hemophiliacs followed at the Regional Center for Hemophilia Midi Pyrénées. Patients were considered eligible if their cardiovascular risk was moderate to high according to the SCORE scale. A cardiovascular screening was performed including assessment of risk factors and detection of peripheral and coronary atheromatous plaque. 45 patients were enrolled from december 2010 to january 2013, including 22 with minor hemophilia; 15 with moderate hemophilia; and 8 severe hemophiliacs. Monitoring was conducted until January 2014. 47% of the patients (10 patients) had a very high cardiovascular risk. For 21 patients (46.7%), the screening led to change cardiovascular medications or to propose invasive treatment. Anti thrombotic treatment was prescribed to 11 patients. 3 patients were treated with double platelet anti-aggregation; 7 with single platelet anti-aggregation and 1 patient with Vitamine K antagonists. No major bleedings were reported. The prevalence of cardiovascular risk factors and of cardiovascular disease in patients with hemophilia is not negligible. Based on a personalized approach, antithrombotic therapies might be prescribed without major bleeding complications.