Atrial fibrillation in patients with haemophilia: a cross‐sectional evaluation in Europe

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Atrial fibrillation in patients with haemophilia: a cross-sectional evaluation in EuropeRoger E. G. Schutgens1,*, R. Klamroth2, I. Pabinger3, M. Malerba4, G. Dolan5 andon behalf of the ADVANCE working groupArticle first published online: 14 APR 2014

DOI: 10.1111/hae.12445

© 2014 John Wiley & Sons Ltd

Issue

HaemophiliaEarly View (Online Version of Record published before inclusion in an issue)

Additional Information

How to CiteSchutgens, R. E. G., Klamroth, R., Pabinger, I., Malerba, M., Dolan, G. and the ADVANCE working group (2014), Atrial fibrillation in patients with haemophilia: a cross-sectional evaluation in Europe. Haemophilia. doi: 10.1111/hae.12445

Author Information1

Van Creveldkliniek, University Medical Center Utrecht, Utrecht, the Netherlands

2

Vivantes-Klinikum, Berlin, Germany

3

Medical University of Vienna, Vienna, Austria

4

Ospedale Maggiore Policlinico, Milan, Italy

5

Nottingham University Hospitals, Nottingham, UK

* Correspondence: Roger E. G. Schutgens, MD, PhD, Department of Hematology/Van Creveldkliniek, University Medical Center Utrecht, Room C01.425, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Tel.: +31 88 7555555; fax: +31 88 7555438;
e-mail: r.schutgens@umcutrecht.nl

Publication HistoryArticle first published online: 14 APR 2014Manuscript Accepted: 22 MAR 2014Funded byBayer HealthcareMichael Holland, Driftwood Publishing Ltd SEARCH Search Scope All contentPublication titlesIn this journalIn this issue Search String Advanced >Saved Searches > SEARCH BY CITATION Volume: Issue: Page: ARTICLE TOOLSGet PDF (109K)Save to My ProfileE-mail Link to this ArticleExport Citation for this ArticleGet Citation AlertsRequest Permissions AbstractArticleReferencesCited By View Full Article (HTML) Enhanced Article (HTML) Get PDF (109K) Keywords:ageing;atrial fibrillation;cardiovascular;comorbidity;haemophiliaSummary

Atrial fibrillation (AF) is a common health problem in the general population, but data on prevalence or management in patients with haemophilia (PWH) are lacking. The aims of this study were to analyse the prevalence of AF and risk factors for stroke using a cross-sectional pan-European design and to document current anticoagulation practice. The ADVANCE Working Group consists of members from 14 European haemophilia centres. Each centre retrieved data on their PWH with AF. From the total of 3952 adult PWH, 33 had AF with a mean age of 69 years (IQR 62–76). Haemophilia was severe in seven (21%), moderate in six (18%) and mild in 20 (61%) patients. The overall AF prevalence was 0.84% and increased with age; 0.42% in patients 40–60 years and 3.4% in patients >60 years. The mean CHA2DS2-Vasc score was 1.3 (range 0–4), predominantly determined by age and hypertension. Hypertension was reported in 48% of PWH with AF. In 11 patients (33%), anticoagulation was started of whom nine aspirin and two vitamin K antagonists. Of these 11 patients, nine had mild haemophilia. Anticoagulation was given in 42% of patients with a CHA2DS2-Vasc score =2. During follow-up (mean 57 months), there were no thrombotic events reported, nor increases in bleeding severity. The prevalence of AF in haemophilia increases with age and is predominantly present in mild haemophilia. PWH have a low stroke risk based on their CHA2DS2-Vasc scores, that might be even lower considering the hypocoagulable state. Only 33% of PWH with AF receives any form of anticoagulation therapy.

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