BACKGROUND: Hemophilia A patients have a lower cardiovascular mortality rate than the general population. Whether this protection is caused by hypocoagulability or decreased atherogenesis is unclear. OBJECTIVES: To evaluate atherosclerosis and endothelial function in hemophilia A patients with and without obesity as well as in matched, unaffected controls. METHODS: Fifty-one obese (body mass index [BMI] ≥ 30 kg m(-2)) and 47 non-obese (BMI ≤ 25 kg m(-2)) hemophilia A patients, and 42 obese and 50 matched non-obese male controls were included. Carotid and femoral intima–media thickness [IMT] and brachial flow-mediated dilatation (FMD) were measured as markers of atherogenesis and endothelial function. RESULTS: The overall population age was 50 ± 13 years. Carotid IMT was increased in obese subjects (0.77 ± 0.22 mm) as compared with non-obese subjects (0.69 ± 0.16 mm) [mean difference 0.07 mm (95% confidence interval [CI] 0.02–0.13, P = 0.008)]. No differences in mean carotid and femoral IMT between obese hemophilic patients and obese controls were found (mean difference of 0.02 mm [95% CI ) 0.07–0.11, P = 0.67], and mean difference of 0.06 mm [95% CI ) 0.13–0.25, P = 0.55], respectively). Thirty-five per cent of the obese hemophilic patients and 29% of the obese controls had an atherosclerotic plaque (P = 0.49), irrespective of the severity of hemophilia. Brachial FMD was comparable between obese hemophilic patients and obese controls (4.84% ± 3.24% and 5.32% ± 2.37%, P = 0.45). CONCLUSION: Hemophilia A patients with obesity develop atherosclerosis to a similar extent as the general male population. Detection and treatment of cardiovascular risk factors in hemophilic patients is equally necessary.
BACKGROUND:Hemophilia Apatients have a lower cardiovascular mortality rate than the general population. Whether this protection is caused by hypocoagulability or decreased atherogenesis is unclear. OBJECTIVES: To evaluate atherosclerosis and endothelial function in hemophilia Apatients with and without obesity as well as in matched, unaffected controls. METHODS: Fifty-one obese (body mass index [BMI] ≥ 30 kg m(-2)) and 47 non-obese (BMI ≤ 25 kg m(-2)) hemophilia Apatients, and 42 obese and 50 matched non-obese male controls were included. Carotid and femoral intima–media thickness [IMT] and brachial flow-mediated dilatation (FMD) were measured as markers of atherogenesis and endothelial function. RESULTS: The overall population age was 50 ± 13 years. Carotid IMT was increased in obese subjects (0.77 ± 0.22 mm) as compared with non-obese subjects (0.69 ± 0.16 mm) [mean difference 0.07 mm (95% confidence interval [CI] 0.02–0.13, P = 0.008)]. No differences in mean carotid and femoral IMT between obese hemophilicpatients and obese controls were found (mean difference of 0.02 mm [95% CI ) 0.07–0.11, P = 0.67], and mean difference of 0.06 mm [95% CI ) 0.13–0.25, P = 0.55], respectively). Thirty-five per cent of the obese hemophilicpatients and 29% of the obese controls had an atherosclerotic plaque (P = 0.49), irrespective of the severity of hemophilia. Brachial FMD was comparable between obese hemophilicpatients and obese controls (4.84% ± 3.24% and 5.32% ± 2.37%, P = 0.45). CONCLUSION:Hemophilia Apatients with obesity develop atherosclerosis to a similar extent as the general male population. Detection and treatment of cardiovascular risk factors in hemophilic patients is equally necessary.
Authors: Jacob J Mayfield; Andrew D Leavitt; Talha Tanriverdi; Krishan Soni; Thomas A Ports; M Roselle Abraham Journal: J Thromb Thrombolysis Date: 2022-05-11 Impact factor: 5.221
Authors: Suman L Sood; Dunlei Cheng; Margaret Ragni; Craig M Kessler; Doris Quon; Amy D Shapiro; Nigel S Key; Marilyn J Manco-Johnson; Adam Cuker; Christine Kempton; Tzu-Fei Wang; M Elaine Eyster; Philip Kuriakose; Annette von Drygalski; Joan Cox Gill; Allison Wheeler; Peter Kouides; Miguel A Escobar; Cindy Leissinger; Sarah Galdzicka; Marshall Corson; Crystal Watson; Barbara A Konkle Journal: Blood Adv Date: 2018-06-12
Authors: Victor A Ferraris; Leonard I Boral; Alice J Cohen; Susan S Smyth; Gilbert C White Journal: Cardiol Rev Date: 2015 Mar-Apr Impact factor: 2.644