Center of Rare Disease and Hemophilia, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan.
Thromb Res. 2015 Mar;135(3):502-7. doi: 10.1016/j.thromres.2014.12.027. Epub 2015 Jan 10.
Reports on the prevalence and risk factors of atherothrombotic events (AEs) are conflicting in persons with hemophilia (PWH).
This study evaluated the prevalence and risk factors of AEs among 1054 male hemophilia patients, using data collected from Taiwan's National Health Insurance Research Database between 1997 and 2010, by comparing variable to those of an unaffected 10540 age- and gender-matched general population.
The proportions of all AEs among PWH, including 26 ischemic stroke, 29 coronary artery disease and 5 peripheral arterial disease were comparable to those in the general population. The mean age at diagnosis of AE among PWH was younger than that in the general population: 49.0 (95% CI, 43.6-54.5) and 55.8 years (95% CI, 54.5-57.0), P = 0.019, respectively. PWH with Chronic Obstructive Pulmonary Disease (COPD), hypertension, and hyperlipidemia were associated with greater risk for the occurrence of AEs, with hazard ratios (95% CI) of 3.42 (1.25-9.38), 4.15 (2.11-8.17), and 2.84 (1.39-5.79), respectively. PWH who needed replacement therapy had a lower risk of AEs than those who did not need, with a hazard ratio (95% CI) of 0.41 (0.21-0.81).
The study indicated the prevalence of AEs among PWH was comparable to that of the general population. AEs appeared at an earlier age among PWH. COPD, hypertension, and hyperlipidemia were risk factors for AEs. PWH who needed replacement therapy may have a lower risk of AEs.
在血友病患者(PWH)中,关于动脉血栓栓塞事件(AEs)的患病率和危险因素的报告存在矛盾。
本研究使用了 1997 年至 2010 年间从台湾全民健康保险研究数据库中收集的数据,评估了 1054 名男性血友病患者中 AEs 的患病率和危险因素,通过将变量与未受影响的 10540 名年龄和性别匹配的一般人群进行比较。
PWH 中所有 AEs 的比例,包括 26 例缺血性中风、29 例冠心病和 5 例外周动脉疾病,与一般人群相当。PWH 中 AE 的平均诊断年龄低于一般人群:49.0(95%置信区间,43.6-54.5)和 55.8 岁(95%置信区间,54.5-57.0),P = 0.019。患有慢性阻塞性肺疾病(COPD)、高血压和高血脂的 PWH 发生 AEs 的风险更高,风险比(95%置信区间)分别为 3.42(1.25-9.38)、4.15(2.11-8.17)和 2.84(1.39-5.79)。需要替代治疗的 PWH 发生 AEs 的风险低于不需要替代治疗的 PWH,风险比(95%置信区间)为 0.41(0.21-0.81)。
该研究表明,PWH 中 AEs 的患病率与一般人群相当。AEs 在 PWH 中出现的年龄更早。COPD、高血压和高血脂是 AEs 的危险因素。需要替代治疗的 PWH 发生 AEs 的风险可能较低。