21371197

PMC3134626

Background

Atherosclerotic heart disease (ASHD) is a common cause of morbidity and mortality in Western society. Few studies have determined prevalence and predictors of ASHD in hemophilia (HA), a population whose survival is improving with safer blood products and effective treatments for AIDS and hepatitis C.

Objectives

The purpose of this study was to determine prevalence and factors associated with ASHD in hemophilia A patients in Pennsylvania.

Methods

The prevalence of ASHD (myocardial infarction, angina, coronary disease), cardiac catheterization, coronary angiography, co-morbidities, and in-hospital mortality were assessed on statewide ASHD discharge data, 2001–2006, from the Pennsylvania Health Care Cost Containment Council (PHC4).

Results

The prevalence of hemophilia ASHD admissions fluctuated between 6.5% and 10.5% for 2001 to 2006, p=0.62. Compared to HA without ASHD, HA with ASHD were older and more likely to be hypertensive, hyperlipidemic, and diabetic, all p<0.0001, with greater severity of illness, p=0.013. By contrast, HA and non-HA with ASHD had similar rates of hypertension, diabetes, and ICD-9 specified ischemic heart disease, including acute myocardial infarction (MI), p=0.39, old MI, p=0.47, and angina, p=0.63. Rates of catheterization and angiography, p=0.06 and p=0.07, were marginally lower, but primary circulatory system admitting diagnoses, p=0.29, were similar between HA and non-HA ASHD groups, as was length of stay, p=0.14, severity of illness, p=0.64, and in-hospital deaths, p=0.75.

Conclusions

Hemophilia patients with ASHD have similar cardiovascular risk factors, admitting diagnoses, severity of illness, and in-hospital mortality as the general population. These findings suggest cardiovascular prevention measures should be promoted in hemophilia.

CDC Public Access

#1-H-30-MC-00038-01/PHS HHS/United States
U10DD000193/DD/NCBDD CDC HHS/United States
UL-1 RR024153/RR/NCRR NIH HHS/United States
UL1 RR024153/RR/NCRR NIH HHS/United States
UL1 RR024153-04/RR/NCRR NIH HHS/United States
UL1 TR000005/TR/NCATS NIH HHS/United States