Abstract
Background: Evaluation of risk factors associated with coronary artery disease and cardiac health in hemophilia patients is necessary to prevent the onset of ischemic heart disease. In this study, we evaluated the cardiovascular status of hemophilic patients in Lorestan province for the early onset of ischemic heart disease.
Methods: In this cross-sectional descriptive study, a total of 80 patients presenting severe hemophilia, a detailed questionnaire-based investigation was conducted to analyze the prevalence of cardiovascular risk factors in severe hemophilic patients. In patients with hemophilia, body mass index (BMI), blood pressure, diabetes, LDL, cholesterol and HDL, the risk of cardiovascular death was estimated using a predictive risk predictor algorithm of Europe SCORE.
Results: The mean age of the patients was 25 years, where all the patients were non-diabetic. Echocardiography did not show any wall motion abnormality and changes in the T wave and dysrhythmia were also not seen by ECG. 7 patients had high blood pressure, 11 had abnormal HDL, and 1 had abnormal LDL. In this study, serum LDL and HDL levels were not significantly correlated with age and BMI. Conversely, age and BMI were significantly associated with hypertension. Hypertension was observed in people over the age of 25 years and in overweighed individuals. 78.8% had normal BMI and 21.3% were overweighed. There was no significant correlation between serum LDL, serum HDL, and blood pressure and sex. The levels of abnormal LDL and HDL were higher in men than in women.
Conclusion: ECG findings from our study did not report any significant cardiac abnormalities among hemophilic patients. Cardiovascular risk factors were not significantly correlated in these patients.
Keywords: Hemophilia, risk Factor, cardiovascular disease, ischemic heart disease, non-diabetic, europe score.
Graphical Abstract
[1]
Green, D.; Snapper, H.; Abu-Jawdeh, G.; Reddy, J. Acute myocardial infarction, non-bacterial thrombotic endocarditis, and disseminated intravascular coagulation in a severe hemophiliac. Am. J. Hematol., 1990, 35(3), 210-212.
[http://dx.doi.org/10.1002/ajh.2830350314] [PMID: 2220767]
[http://dx.doi.org/10.1002/ajh.2830350314] [PMID: 2220767]
[2]
DiMichele, D.; Neufeld, E.J. Hemophilia. A new approach to an old disease. Hematol. Oncol. Clin. North Am., 1998, 12(6), 1315-1344.
[http://dx.doi.org/10.1016/S0889-8588(05)70054-X] [PMID: 9922937]
[http://dx.doi.org/10.1016/S0889-8588(05)70054-X] [PMID: 9922937]
[4]
Rotblat, F.; Goodall, A.H.; O’Brien, D.P.; Rawlings, E.; Middleton, S.; Tuddenham, E.G. Monoclonal antibodies to human procoagulant factor VIII. J. Lab. Clin. Med., 1983, 101(5), 736-746.
[PMID: 6403638]
[PMID: 6403638]
[5]
Hopkins, P.N.; Wu, L.L.; Hunt, S.C.; Brinton, E.A. Plasma triglycerides and type III hyperlipidemia are independently associated with premature familial coronary artery disease. J. Am. Coll. Cardiol., 2005, 45(7), 1003-1012.
[http://dx.doi.org/10.1016/j.jacc.2004.11.062] [PMID: 15808755]
[http://dx.doi.org/10.1016/j.jacc.2004.11.062] [PMID: 15808755]
[6]
Salarifar, M.; Kazemeini, S.A.M.H.Z. Prevalence of Coronary Artery Disease and related risk factors in first degree relatives of patients with premature CAD Tehran Heart Center. Tehran University Medical Journal TUMS Publications., 2008, 65(1), 49-54.
[7]
Krumholz, H.M.; Wang, Y.; Chen, J.; Drye, E.E.; Spertus, J.A.; Ross, J.S.; Curtis, J.P.; Nallamothu, B.K.; Lichtman, J.H.; Havranek, E.P.; Masoudi, F.A.; Radford, M.J.; Han, L.F.; Rapp, M.T.; Straube, B.M.; Normand, S.L. Reduction in acute myocardial infarction mortality in the United States: Risk-standardized mortality rates from 1995-2006. JAMA, 2009, 302(7), 767-773.
[http://dx.doi.org/10.1001/jama.2009.1178] [PMID: 19690309]
[http://dx.doi.org/10.1001/jama.2009.1178] [PMID: 19690309]
[8]
Andreoli, TE; Fitz, JG; Benjamin, I; Griggs, RC Wing, EJ. Andreoli and Carpenter's Cecil Essentials of Medicine E-Book: Elsevier Health Sciences. 2010.
[9]
Tarhani, F.; Nezami, A. Role of probiotics in treatment of congenital heart disease and necrotizing enterocolitis. PharmaNutrition, 2019, 8, 100144.
[http://dx.doi.org/10.1016/j.phanu.2019.100144]
[http://dx.doi.org/10.1016/j.phanu.2019.100144]
[10]
Taee, N.; Goodarzi, M.F.; Safdari, M.; Bajelan, A. Pentalogy of cantrell in full term neonate. AJP Rep., 2019, 9(2), e144-e146.
[http://dx.doi.org/10.1055/s-0039-1683936] [PMID: 30972230]
[http://dx.doi.org/10.1055/s-0039-1683936] [PMID: 30972230]
[11]
Kulkarni, R.; Soucie, J.M.; Evatt, B.L. Hemophilia Surveillance System Project Investigators. Prevalence and risk factors for heart disease among males with hemophilia. Am. J. Hematol., 2005, 79(1), 36-42.
[http://dx.doi.org/10.1002/ajh.20339] [PMID: 15849761]
[http://dx.doi.org/10.1002/ajh.20339] [PMID: 15849761]
[12]
Tarhani, F.; Jafrasteh, A.; Garmsiri, M.; Dalvand, S. Risk factors of resistance to intravenous immunoglobulin in patients with Kawasaki: A cross-sectional study over a 10 year period (2006-2016). World Fam. Med. J., 2017, 99(4216), 1-7.
[http://dx.doi.org/10.5742/MEWFM.2017.92982]
[http://dx.doi.org/10.5742/MEWFM.2017.92982]
[13]
Sanders, Y.V.; Eikenboom, J.; de Wee, E.M.; van der Bom, J.G.; Cnossen, M.H.; Degenaar-Dujardin, M.E.; Fijnvandraat, K.; Kamphuisen, P.W.; Laros-van Gorkom, B.A.; Meijer, K.; Mauser-Bunschoten, E.P.; Leebeek, F.W. WiN Study Group. Reduced prevalence of arterial thrombosis in von Willebrand disease. J. Thromb. Haemost., 2013, 11(5), 845-854.
[http://dx.doi.org/10.1111/jth.12194] [PMID: 23506463]
[http://dx.doi.org/10.1111/jth.12194] [PMID: 23506463]
[14]
Mousavinasab, N.; Yazdani Cherat, J.; Bagheri, B.; Bakhti, F-s.; Bakhti, Z. Identifying the risk factors for cardiovascular disease in individuals aged above 35 years using logistic regression model. Majallah-i Danishgah-i Ulum-i Pizishki-i Mazandaran, 2017, 26(144), 50-56.
[15]
Pooria, A.; Azadbakht, M.; Khoshdani-Farahani, P.; Pourya, A. Sigmoid volvulus after CABG surgery. Clin. Case Rep., 2020, 8(4), 606-611.
[http://dx.doi.org/10.1002/ccr3.2668] [PMID: 32274020]
[http://dx.doi.org/10.1002/ccr3.2668] [PMID: 32274020]
[16]
Goff, D.C., Jr; Lloyd-Jones, D.M.; Bennett, G.; Coady, S.; D’Agostino, R.B., Sr; Gibbons, R.; Greenland, P.; Lackland, D.T.; Levy, D.; O’Donnell, C.J.; Robinson, J.G.; Schwartz, J.S.; Shero, S.T.; Smith, S.C., Jr; Sorlie, P.; Stone, N.J.; Wilson, P.W.F. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol., 2014, 63(25), 2935-2959.
[17]
Pooria, A.; Pourya, A. Gheini, A. Postoperative complications associated with coronary artery bypass graft surgery and their therapeutic interventions. Future Cardiol., 2020, 16(5), 481-496.
[http://dx.doi.org/10.2217/fca-2019-0049]
[http://dx.doi.org/10.2217/fca-2019-0049]
[18]
Ghafarzadeh, M.; Namdari, P.; Tarhani, M.; Tarhani, F. A review of application of stem cell therapy in the management of congenital heart disease. J. Matern. Fetal Neonatal Med., 2018, 1-9. 1607.
[PMID: 30185081]
[PMID: 30185081]
[19]
Sood, S.L.; Cheng, D.; Ragni, M.; Kessler, C.M.; Quon, D.; Shapiro, A.D.; Key, N.S.; Manco-Johnson, M.J.; Cuker, A.; Kempton, C.; Wang, T.F.; Eyster, M.E.; Kuriakose, P.; von Drygalski, A.; Gill, J.C.; Wheeler, A.; Kouides, P.; Escobar, M.A.; Leissinger, C.; Galdzicka, S.; Corson, M.; Watson, C.; Konkle, B.A. A cross-sectional analysis of cardiovascular disease in the hemophilia population. Blood Adv., 2018, 2(11), 1325-1333.
[http://dx.doi.org/10.1182/bloodadvances.2018018226] [PMID: 29895623]
[http://dx.doi.org/10.1182/bloodadvances.2018018226] [PMID: 29895623]
[20]
Foley, C.J.; Nichols, L.; Jeong, K.; Moore, C.G.; Ragni, M.V. Coronary atherosclerosis and cardiovascular mortality in hemophilia. J. Thromb. Haemost., 2010, 8(1), 208-211.
[http://dx.doi.org/10.1111/j.1538-7836.2009.03669.x] [PMID: 19874455]
[http://dx.doi.org/10.1111/j.1538-7836.2009.03669.x] [PMID: 19874455]
[21]
Gholami, M.; Najafizadeh, H.; Teimouri, H.; Ardalan, A.; Pooria, A.; Tarrahi, M.J. The combined effect of vitamin C and omega-3 polyunsaturated fatty acids on fatigue following coronary artery bypass graft surgery: A triple-blind clinical trial. J. Complement. Integr. Med., 2019, 16(4) J/Jcim.2019.16.
[http://dx.doi.org/10.1515/jcim-2018-0113] [PMID: 31433781]
[http://dx.doi.org/10.1515/jcim-2018-0113] [PMID: 31433781]
[22]
Sharathkumar, AA; Soucie, JM; Trawinski, B; Greist, A; Shapiro, AD. Prevalence and risk factors of cardiovascular disease (CVD) events among patients with haemophilia: Experience of a single haemophilia treatment centre in the United States (US). Haemophilia, 2011, 17(4), 597-604.
[23]
Tuinenburg, A.; Mauser-Bunschoten, E.P.; Verhaar, M.C.; Biesma, D.H.; Schutgens, R.E. Cardiovascular disease in patients with hemophilia. J. Thromb. Haemost., 2009, 7(2), 247-254.
[http://dx.doi.org/10.1111/j.1538-7836.2008.03201.x] [PMID: 18983484]
[http://dx.doi.org/10.1111/j.1538-7836.2008.03201.x] [PMID: 18983484]
[24]
Pooria, A.; Pourya, A.; Gheini, A. Animal- and human-based evidence for the protective effects of stem cell therapy against cardiovascular disorders. J. Cell. Physiol., 2019, 234(9), 14927-14940.
[http://dx.doi.org/10.1002/jcp.28330] [PMID: 30811030]
[http://dx.doi.org/10.1002/jcp.28330] [PMID: 30811030]
[25]
Sousos, N.; Gavriilaki, E.; Vakalopoulou, S.; Garipidou, V. Understanding cardiovascular risk in hemophilia: A step towards prevention and management. Thromb. Res., 2016, 140, 14-21.
[http://dx.doi.org/10.1016/j.thromres.2016.02.001] [PMID: 27046799]
[http://dx.doi.org/10.1016/j.thromres.2016.02.001] [PMID: 27046799]
[26]
Biere-Rafi, S.; Zwiers, M.; Peters, M.; van der Meer, J.; Rosendaal, F.R.; Büller, H.R.; Kamphuisen, P.W. The effect of haemophilia and von Willebrand disease on arterial thrombosis: A systematic review. Neth. J. Med., 2010, 68(5), 207-214.
[PMID: 20508269]
[PMID: 20508269]
[27]
Salem, Z.; Rezaeian, M. Blood pressure status and its association with obesity and abdominal obesity in students of Rafsanjan University of Medical Sciences in 2007. Majallah-i Ilmi-i Danishgah-i Ulum-i Pizishki-i Rafsanjan, 2008, 7(3), 157-164.
[28]
Biere-Rafi, S.; Baarslag, M.A.; Peters, M.; Kruip, M.J.A.; Kraaijenhagen, R.A.; Den Heijer, M.; Büller, H.R.; Kamphuisen, P.W. Cardiovascular risk assessment in haemophilia patients. Thromb. Haemost., 2011, 105(2), 274-278.
[http://dx.doi.org/10.1160/TH10-07-0460] [PMID: 21136012]
[http://dx.doi.org/10.1160/TH10-07-0460] [PMID: 21136012]
[29]
Zhang, Y.X.; Wang, M.; Chu, Z.H.; Xie, L. Prevalence of relatively high blood pressure among children and adolescents with different body mass index and subcutaneous fat cut-offs. Int. J. Cardiol., 2015, 179, 536-538.
[http://dx.doi.org/10.1016/j.ijcard.2014.10.163] [PMID: 25466559]
[http://dx.doi.org/10.1016/j.ijcard.2014.10.163] [PMID: 25466559]
[30]
Azizi, A.; Abasi, M.; Abdoli, G. The prevalence of hypertension and its association with age, sex and BMI in a population being educated using community-based medicine in Kermanshah: 2003. Majallah-i Ghudad-i Darun/Riz va Mitabulism-i Iran, 2008, 10(4), 323-329.
[31]
Girolami, A.; Ruzzon, E.; Fabris, F.; Varvarikis, C.; Sartori, R.; Girolami, B. Myocardial infarction and other arterial occlusions in hemophilia A patients. Acta Haematol., 2006, 116(2), 120-125.
[http://dx.doi.org/10.1159/000093642] [PMID: 16914907]
[http://dx.doi.org/10.1159/000093642] [PMID: 16914907]
[32]
Rosendaal, F.R.; Briët, E.; Stibbe, J.; van Herpen, G.; Leuven, J.A.; Hofman, A.; Vandenbroucke, J.P. Haemophilia protects against ischaemic heart disease: A study of risk factors. Br. J. Haematol., 1990, 75(4), 525-530.
[http://dx.doi.org/10.1111/j.1365-2141.1990.tb07793.x] [PMID: 2207003]
[http://dx.doi.org/10.1111/j.1365-2141.1990.tb07793.x] [PMID: 2207003]
[33]
Bønaa, K.H.; Thelle, D.S. Association between blood pressure and serum lipids in a population. The Tromsø Study. Circulation, 1991, 83(4), 1305-1314.
[http://dx.doi.org/10.1161/01.CIR.83.4.1305] [PMID: 2013148]
[http://dx.doi.org/10.1161/01.CIR.83.4.1305] [PMID: 2013148]
[34]
Recht, M.; Lentz, S.R.; Zupancic-alek, S.; Matytsina, I.; Landorph, A.; Saugstrup, T. Factor VIII dosing and preventive efficacy in obese patients with hemophilia (BMI≥ 30 kg/m2)–a post-hoc sub-analysis of the guardian™ trials. Blood, 2014, 124(21), 1503.
[http://dx.doi.org/10.1182/blood.V124.21.1503.1503]
[http://dx.doi.org/10.1182/blood.V124.21.1503.1503]
[35]
Calhoun, D.A.; Jones, D.; Textor, S.; Goff, D.C.; Murphy, T.P.; Toto, R.D.; White, A.; Cushman, W.C.; White, W.; Sica, D.; Ferdinand, K.; Giles, T.D.; Falkner, B.; Carey, R.M. American Heart Association Professional Education Committee. Resistant hypertension: Diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation, 2008, 117(25), e510-e526.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.189141] [PMID: 18574054]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.189141] [PMID: 18574054]
[36]
Biere-Rafi, S.; Haak, B.W.; Peters, M.; Gerdes, V.E.; Büller, H.R.; Kamphuisen, P.W. The impairment in daily life of obese haemophiliacs. Haemophilia, 2011, 17(2), 204-208.
[http://dx.doi.org/10.1111/j.1365-2516.2010.02417.x] [PMID: 21332881]
[http://dx.doi.org/10.1111/j.1365-2516.2010.02417.x] [PMID: 21332881]
[37]
Soucie, J.M.; Wang, C.; Siddiqi, A.; Kulkarni, R.; Recht, M.; Konkle, B.A. Hemophilia Treatment Center Network. The longitudinal effect of body adiposity on joint mobility in young males with Haemophilia A. Haemophilia, 2011, 17(2), 196-203.
[http://dx.doi.org/10.1111/j.1365-2516.2010.02400.x] [PMID: 21332880]
[http://dx.doi.org/10.1111/j.1365-2516.2010.02400.x] [PMID: 21332880]
[38]
Soucie, J.M.; Cianfrini, C.; Janco, R.L.; Kulkarni, R.; Hambleton, J.; Evatt, B.; Forsyth, A.; Geraghty, S.; Hoots, K.; Abshire, T.; Curtis, R.; Forsberg, A.; Huszti, H.; Wagner, M.; White, G.C., II Joint range-of-motion limitations among young males with hemophilia: prevalence and risk factors. Blood, 2004, 103(7), 2467-2473.
[http://dx.doi.org/10.1182/blood-2003-05-1457] [PMID: 14615381]
[http://dx.doi.org/10.1182/blood-2003-05-1457] [PMID: 14615381]
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