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Introduction Improvements in haemophilia care have increased life expectancy in persons with haemophilia ( PWH). This ageing population presents clinicians with management challenges as they develop age-related comorbidities such as cardiovascular disease ( CVD). Aims To assess the epidemiology of CVD risk factors and events in an ageing Canadian haemophilia population. Methods A retrospective, multicentre chart review was carried out at five Canadian Hemophilia Treatment Centres. PWH (A and B) ≥35 years old were included and data were extracted on CVD risk factors and events. Results Data from 294 patients' charts were analysed including 222 (75.5%) patients with haemophilia A and 72 (24.5%) patients with haemophilia B with a median age at end of follow-up of 54 years (range = 36-90). Mean follow-up duration was 5.86 years. Cardiovascular risk factors were common: hypertension 31.3% ( n = 90), diabetes mellitus 10.5% ( n = 29), smoking 21.8% ( n = 61), obesity 27.6% ( n = 69), dyslipidaemia 22.4% ( n = 65), family history 8.5% ( n = 24), antiretroviral therapy 12.2% ( n = 36). There were 24 CVD events (8.2% of the population) with a median age at event of 63 years (range = 46-83). Events consisted of coronary artery disease ( CAD), 14; cerebrovascular disease, 4; and atrial fibrillation, 7. CAD was treated with coronary artery bypass grafting in three patients and percutaneous coronary intervention in nine patients. CVD events were complicated by six bleeding events (three minor and three major). Conclusion Cardiovascular disease risk factors and events are relatively common in PWH. PWH can be safely treated for CVD events with similar procedures as the non- PWH populations, though specific clotting factor prophylaxis protocols are not well defined. [ABSTRACT FROM AUTHOR]

The prevalence of cardiovascular disease ( CVD) risk and events in patients with haemophilia ( PWH) is expected to increase as the longevity of this cohort increases due to treatment advances since the 1950s. The aims of this study were to assess publications of CVD and haemophilia for robustness, determine if the increasing longevity of PWH and associated age-related CVD risk factors result in CVD events; assess the need for an extension of the circle of care for ageing PWH due to the shift in comorbidities. A scoping review was conducted, resulting in a final pool of 30 articles which were organized based on publication dates. A matrix was created to illustrate which articles cited articles published prior to its own publication. This led to the identification of the primary articles, receiving the highest number of citations by other publications, which drive the research pertaining to the study of age-related risk factors of CVD in PWH. The scoping review revealed 14 original articles, four of which indicated a protective effect of haemophilia toward CVD. Twelve articles demonstrated a similar prevalence of CVD in PWH compared to the general population while seven articles concluded a difference in the prevalence of CVD in the ageing haemophilia population. The existing literature presented conflicting evidence regarding the possibility of a protective effect of haemophilia against CVD. The scoping review was not able to finalize whether the longevity of PWH and their associated age-related CVD risk factors result in CVD events because the articles assessed reported conflicting results. [ABSTRACT FROM AUTHOR]

The article focuses on the robotic coronary artery bypass surgery in a haemophilia A patient. Topics discussed include access to safe recombinant coagulation factor concentrates (CFCs) which resulted into prolonged life expectancy for person with haemophilia (PWH), management of cardiovascular disease in PWH, and bifurcation stenting of lesion which is required in percutaneous coronary intervention (PCI).