Platelet inhibition and bleeding complications in patients with haemophilia/von Willebrand's disease and coronary artery disease

Presentation and management of acute coronary syndromes among adult persons with haemophilia: results of an international, retrospective, 10‐year survey

“…To our knowledge, this report represents the largest series to date on the presentation and management of ACS events in PWH. [17,18] Our data collection records details regarding the medical and interventional management of ACS, including haemostatic coverage strategies in the acute and in the chronic setting, which have been investigated to some extent previously [10,17]. In our series, interventional management of ACS in haemophilia patients seemed generally safe despite many different approaches to management of the bleeding risk due to the underlying coagulation disorder.…”

“…[17,18] Our data collection records details regarding the medical and interventional management of ACS, including haemostatic coverage strategies in the acute and in the chronic setting, which have been investigated to some extent previously [10,17]. [17,18] Our data collection records details regarding the medical and interventional management of ACS, including haemostatic coverage strategies in the acute and in the chronic setting, which have been investigated to some extent previously [10,17].…”

“…The tolerability of such approaches among patients with congenital bleeding disorders is limited to small case series [10,11]. In addition, invasive procedures such as PCI, deployment of bare metal stents (BMS) or drug-eluting stents (DES) and/or coronary artery bypass grafting (CABG) may be required for definitive revascularization.…”

“…In addition, invasive procedures such as PCI, deployment of bare metal stents (BMS) or drug-eluting stents (DES) and/or coronary artery bypass grafting (CABG) may be required for definitive revascularization. The tolerability of such approaches among patients with congenital bleeding disorders is limited to small case series [10,11]. Furthermore, published suggestions including radial (as opposed to femoral) arterial access during PCI or doses of factor replacement therapies during acute and chronic management of ACS in PWH have not been validated [12][13][14].…”

Arterial and Venous Thrombosis in Haemophilia Patients: Experiences from a Danish Haemophilia Centre

“…However, recent guidelines and expert opinions [10,11,12,13,14,17] advocate that acute coronary disease in PWH should generally be managed as in non-PWH, provided that factor replacement is given, and they consider ASA therapy (with factor levels >5%) and dual anti-platelet therapy (with factor levels >15-30%) to be generally safe. This is supported by 2 recently published case series on 24 PWH with CVD [18,19], who found that revascularization and anti-platelet treatment were generally well-tolerated. The 2 cases of PCI and 4 cases of CABG reported in our population were all successful and without bleeding complications.…”