Factor VIII deficiency does not protect against atherosclerosis
Article first published online: 4 JAN 2012
© 2011 International Society on Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis
Volume 10, Issue 1, pages 30–37, January 2012
How to Cite
BIERE-RAFI, S., TUINENBURG, A., HAAK, B. W., PETERS, M., HUIJGEN, R., de GROOT, E., VERHAMME, P., PEERLINCK, K., VISSEREN, F. L. J., KRUIP, M. J. H. A., LAROS-van GORKOM, B. A. P., GERDES, V. E. A., BULLER, H. R., SCHUTGENS, R. E. G. and KAMPHUISEN, P. W. (2012), Factor VIII deficiency does not protect against atherosclerosis. Journal of Thrombosis and Haemostasis, 10: 30–37. doi: 10.1111/j.1538-7836.2011.04499.x
- Issue published online: 4 JAN 2012
- Article first published online: 4 JAN 2012
- Accepted manuscript online: 5 OCT 2011 10:49AM EST
- Received 5 July 2011, accepted 26 August 2011
- cardiovascular disease;
- intima–media thickness
See also Makris M, van Veen JJ. Reduced cardiovascular mortality in hemophilia despite normal atherosclerotic load. This issue, pp 20–2; Zwiers M, Lefrandt JD, Mulder DJ, Smit AJ, Gans ROB, Vliegenthart R, Brands-Nijenhuis AVM, Kluin-Nelemans JC, Meijer K. Coronary artery calcification score and carotid intima–media thickness in patients with hemophilia. This issue, pp 23–9.
Summary. Background: Hemophilia A patients have a lower cardiovascular mortality rate than the general population. Whether this protection is caused by hypocoagulability or decreased atherogenesis is unclear. Objectives: To evaluate atherosclerosis and endothelial function in hemophilia A patients with and without obesity as well as in matched, unaffected controls. Methods: Fifty-one obese (body mass index [BMI] ≥ 30 kg m−2) and 47 non-obese (BMI ≤ 25 kg m−2) hemophilia A patients, and 42 obese and 50 matched non-obese male controls were included. Carotid and femoral intima–media thickness [IMT] and brachial flow-mediated dilatation (FMD) were measured as markers of atherogenesis and endothelial function. Results: The overall population age was 50 ± 13 years. Carotid IMT was increased in obese subjects (0.77 ± 0.22 mm) as compared with non-obese subjects (0.69 ± 0.16 mm) [mean difference 0.07 mm (95% confidence interval [CI] 0.02–0.13, P = 0.008)]. No differences in mean carotid and femoral IMT between obese hemophilic patients and obese controls were found (mean difference of 0.02 mm [95% CI − 0.07–0.11, P = 0.67], and mean difference of 0.06 mm [95% CI − 0.13–0.25, P = 0.55], respectively). Thirty-five per cent of the obese hemophilic patients and 29% of the obese controls had an atherosclerotic plaque (P = 0.49), irrespective of the severity of hemophilia. Brachial FMD was comparable between obese hemophilic patients and obese controls (4.84% ± 3.24% and 5.32% ± 2.37%, P = 0.45). Conclusion: Hemophilia A patients with obesity develop atherosclerosis to a similar extent as the general male population. Detection and treatment of cardiovascular risk factors in hemophilic patients is equally necessary.