Consensus review of the treatment of cardiovascular disease in people with hemophilia A and B

Victor A. Ferraris, Leonard I. Boral, Alice J. Cohen, Susan S. Smyth, Gilbert C. White

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

With advances in care, increasing numbers of people with hemophilia (PWH) achieve near-normal life expectancies and present with typical age-related cardiovascular conditions. Evidence-based guidelines for medical or surgical management of cardiovascular conditions in individuals with hemophilia are limited. Published recommendations exist for the management of some common cardiovascular conditions (eg, ischemic heart disease, atrial fibrillation), but identifying optimal strategies for anticoagulant or antithrombotic therapy constitutes the primary challenge of managing nonoperative cardiovascular disease (CVD) in PWH. In general, as long as factor concentrates or other hemostatic therapies maintain adequate hemostasis, the recommended medical and surgical management of CVD in PWH parallels that in individuals without hemophilia. The presence of factor inhibitors complicates hemophilia management. Published outcomes of CVD treatment in PWH are similar to those in the general population. Specific knowledge about factor replacement, factor inhibitors, and disease-specific treatment distinguishes the cardiovascular care of PWH from similar care of individuals without this rare bleeding disorder. Furthermore, a multidisciplinary approach incorporating a hematologist with an onsite coagulation laboratory, ideally associated with a hemophilia treatment center, is integral to the management of CVD in PWH.

Original languageEnglish
Pages (from-to)53-68
Number of pages16
JournalCardiology in Review
Volume23
Issue number2
DOIs
StatePublished - Feb 13 2015

Bibliographical note

Publisher Copyright:
© 2015 by Lippincott Williams & Wilkins.

Keywords

  • Atherosclerosis
  • Atrial fibrillation
  • Cardiac surgery
  • Cardiovascular diseases
  • Hemophilia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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