Haemophilia and cardiovascular disease in Japan: Low incidence rates from ADVANCE Japan baseline data

Abstract

IntroductionWith the increasing life expectancy of people with haemophilia, the risk of cardiovascular disease (CVD) and thrombotic events has become a growing concern. Longitudinal studies on the incidence and risk factors of CVD in this population are limited, and optimal prevention and treatment strategies are yet to be established.AimThis study aimed to present the baseline data of a prospective longitudinal study focusing on a subset of Japanese patients with haemophilia, specifically investigated the incidence, risk factors and treatment modalities for CVD and thrombotic diseases in people aged 40 years in Japan over 10 years through the ADVANCE Japan study.MethodsThe ADVANCE Japan study is a prospective multicentre cohort study involving 600 adult individuals with haemophilia A/B aged 40 years in Japan. The primary endpoint was the incidence of CVD, with secondary endpoints encompassing anticoagulant use, mortality rates, and comparison with the general population.ResultsBaseline data from the 600 participants revealed that thrombotic events occurred in 13 individuals (2.2%), mostly in those with haemophilia A. Atrial fibrillation was observed in 11 participants (1.8%). Hypertension and dyslipidaemia were identified as the prevalent risk factors. Various prophylactic treatments were employed, and no severe bleeding events were observed during the study period.ConclusionThis study provides vital baseline data for a 10‐year prospective investigation of CVD and thrombotic disease risk in people with haemophilia. These findings will contribute to refining prevention and treatment approaches and improving patients’ quality of life.

Treatment of thrombotic cardiovascular diseases in people with haemophilia: A Japanese consensus study

“…18 The prevalence of hypertension (≥140/90 mmHg) in Japanese PWH is equal to that of the general population, but studies of Western populations have shown hypertension to be more prevalent in PWH than the general population; incidences of hypertension in PWH may increase as the population of PWH ages. 14,19 PWH are at a much greater risk for developing intracranial haemorrhage (ICH), which is associated with a mortality rate of approximately 20%. 19 ICH occurs most frequently…”

“…For 33 statements, respondents were offered a 4point Likert scale ('strongly disagree' , 'tend to disagree' , 'tend to agree' and 'strongly agree') to indicate their corresponding level of agreement with each statement. Eight additional Likert scale statements in conducting ADVANCE Japan, a prospective longitudinal registry study of a subset of Japanese patients with haemophilia to investigate the incidence, risk factors and treatment approaches for CVD and thrombotic diseases 14. Although the identities of potential responders were known, individual responses were anonymous, and no identifying data were collected.…”