Prevalence and risk factors for heart disease among males with hemophilia

• Published in: American journal of hematology Vol. 79; no. 1; pp. 36 - 42
• Main Authors: Kulkarni, Roshni, Soucie, J. Michael, Evatt, Bruce L.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.05.2005; Wiley-Liss
• Subjects: acute myocardial infarction; Adult; Biological and medical sciences; Cause of Death; coronary heart disease; epidemiology; Hematologic and hematopoietic diseases; hemophilia; Hemophilia A - complications; Hemophilia B - complications; Hospitalization - statistics & numerical data; Humans; Male; Medical sciences; Middle Aged; Myocardial Ischemia - epidemiology; Myocardial Ischemia - mortality; Platelet diseases and coagulopathies; Prevalence; Risk Factors; United States; United States; Prevalence; Hematology; Cardiovascular disease; Male; Hemopathy; Epidemiology; Genetic disease; Heart disease; Risk factor; Hemophilia; coronary heart disease; Coagulopathy; acute myocardial infarction
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.20339

There have been conflicting reports in the literature about the protective effect of hemophilia on the occurrence of ischemic heart disease (IHD). Circulatory disease has been reported as the second most common cause of death in persons with hemophilia in the United States. In addition to diabetes and hypertension, high levels of FVIII, as may occur during factor concentrate infusions, may increase IHD risk in this population. To estimate the prevalence of heart disease and examine factors associated with IHD and other heart diseases among persons with hemophilia, we analyzed data collected from the medical records of 3,422 males with hemophilia living in six U.S. states from 1993 to 1998. Heart disease cases were ascertained from among 2,075 persons who were hospitalized at least once during the 6‐year period. Of these, 48 were diagnosed with IHD and 106, with other types of heart disease. The age‐specific prevalence of IHD ranged from 0.05% in those under 30 years to 15.2% in those 60 years or older. Hospital discharge rates in males with hemophilia with IHD and other types of heart disease were lower compared to rates in age‐matched U.S. males. In our cohort, as in the general population, IHD was independently associated with age, hypertension, diabetes, and hyperlipidemia. Other heart diseases were associated with HIV infection, hypertension, hemophilia B, and diabetes. In summary, persons with hemophilia have unique risk factors such as infusion of factor concentrates and infection with HIV that may predispose them to heart disease as their life expectancy increases. Am. J. Hematol. 79:36–42, 2005. © 2005 Wiley‐Liss, Inc.