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成年血友病患者的心血管危险因素。

Cardiovascular risk factors among adult patients with haemophilia.

机构信息

Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 2nd Floor, Room 255, Belo Horizonte, MG, 30130-100, Brazil.

Fundacao de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, Brazil.

出版信息

Int J Hematol. 2021 Jun;113(6):884-892. doi: 10.1007/s12185-021-03104-y. Epub 2021 Mar 7.

Abstract

Since the introduction of episodic and prophylactic treatments with safer factor concentrates, the life expectancy of people with haemophilia (PwH) has improved considerably. Ageing-related diseases such as cardiovascular disease (CVD) have also become more prevalent in PwH. This cross-sectional study aimed to evaluate CVD risk factors and estimate 10-year risk for CVD events among PwH. Male patients ≥ 30 years were interviewed and examined. Blood tests were performed at the local laboratory. Eighty-two patients were included, of whom 83% had haemophilia A and half had severe disease. Median age at study entry was 43.0 years (interquartile range [IQR], 36.0-51.3). Prevalence of obesity, systemic arterial hypertension (SAH) and diabetes mellitus were 16%, 60% and 16%, respectively. Hypertriglyceridaemia, hypercholesterolaemia and low HDL blood levels were present in 18%, 41% and 30% of patients, respectively. Metabolic syndrome was found in 37%. The Framingham Risk Score showed that 39% of PwH had a high risk of developing cardiovascular events in the following 10 years. We conclude that, in this cohort, PwH have a higher prevalence of SAH when compared with Brazilian men without haemophilia and about two-fifths have a high risk of developing a CVD event in the following 10 years.

摘要

自采用更安全的因子浓缩物进行间歇性和预防性治疗以来,血友病患者(PwH)的预期寿命有了显著提高。与年龄相关的疾病,如心血管疾病(CVD),在 PwH 中也变得更为普遍。本横断面研究旨在评估 CVD 风险因素,并估计 PwH 发生 CVD 事件的 10 年风险。对年龄≥30 岁的男性患者进行访谈和检查。在当地实验室进行血液检查。共纳入 82 名患者,其中 83%为血友病 A,一半为重度疾病。研究入组时的中位年龄为 43.0 岁(四分位距 [IQR],36.0-51.3)。肥胖、系统性动脉高血压(SAH)和糖尿病的患病率分别为 16%、60%和 16%。分别有 18%、41%和 30%的患者存在高甘油三酯血症、高胆固醇血症和低 HDL 血水平。37%的患者存在代谢综合征。Framingham 风险评分显示,39%的 PwH 在未来 10 年内发生心血管事件的风险较高。我们的结论是,在本队列中,与没有血友病的巴西男性相比,PwH 的 SAH 患病率更高,大约五分之二的患者在未来 10 年内有发生 CVD 事件的高风险。

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