Comparing Safety and Efficacy of Dabigatran and Factor Xa Inhibitors for Stroke Prevention in Hemophiliacs with Non-Valvular Atrial Fibrillation

Howard, Austin; Rojas-Delgado, Francia; Schutt, Robert C.; Cheng, Jie; Mathuria, Nilesh

doi:10.4022/jafib.2257

Cited by 1 publication

(1 citation statement)

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“… 35 , 46 , 54 When oral anticoagulation is implemented, we recommend DOAC instead of VKA due to the lower risk of cerebral hemorrhage. 55 , 56 However, information on the safety of DOAC, as well as their efficacy and at which dosage, is not yet available in PWH with AF owing to the lack of adequately powered trials. In practice, we prefer to use DOAC at the lower recommended daily dosages, i.e., those for older patients and for those with renal impairment.…”

Section: Management Of Cardiovascular Diseasesmentioning

confidence: 99%

How we manage cardiovascular disease in patients with hemophilia

Franchini

Focosi²,

Mannucci

2023

haematol

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With the striking advances in hemophilia care that materialized particularly in the last two decades, an increasing number of persons with hemophilia (PWH) have achieved a quality of life and life expectancy very close to that of unaffected individuals. With aging, a growing number of PWH develop age-related co-morbidities, including cancer and cardiovascular disease. The latter (particularly coronary artery disease and atrial fibrillation) represent a new challenge for the hemophilia treatment centers because their management implies a delicate balance between the thrombotic risk and bleeding tendency, that is further enhanced by the concomitant use of antithrombotic agents. Because evidence from clinical trials is lacking, the management of PWH with cardiovascular diseases is mostly based on expert opinions, personal experiences and the adaptation of the evidence stemming from studies on people without hemophilia. In this article, we focus on how to manage coronary artery disease and atrial fibrillation.

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