Schutgens, Roger EG;
Jimenez-Yuste, Victor;
Escobar, Miguel;
Falanga, Anna;
Gigante, Bruna;
Klamroth, Robert;
Lassila, Riitta;
... Castaman, Giancarlo; + view all
(2023)
Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance.
HemaSphere
, 7
(6)
, Article e900. 10.1097/HS9.0000000000000900.
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Abstract
Cardiovascular disease is an emerging medical issue in patients with hemophilia (PWH) and its prevalence is increasing up to 15% in PWH in the United States. Atrial fibrillation, acute and chronic coronary syndromes, venous thromboembolism, and cerebral thrombosis are frequent thrombotic or prothrombotic situations, which require a careful approach to fine-tune the delicate balance between thrombosis and hemostasis in PWH when using both procoagulant and anticoagulant treatments. Generally, PWH could be considered as being naturally anticoagulated when clotting factors are <20 IU/dL, but specific recommendations in patients with very low levels according to the different clinical situations are lacking and mainly based on the anecdotal series. For PWH with baseline clotting factor levels >20 IU/dL in need for any form of antithrombotic therapy, usually treatment without additional clotting factor prophylaxis could be used, but careful monitoring for bleeding is recommended. For antiplatelet treatment, this threshold could be lower with single-antiplatelet agent, but again factor level should be at least 20 IU/dL for dual antiplatelet treatment. In this complex growing scenario, the European Hematology Association in collaboration with the International Society on Thrombosis and Haemostasis, the European Association for Hemophilia and Allied Disorders, the European Stroke Organization, and a representative of the European Society of Cardiology Working Group on Thrombosis has produced this current guidance document to provide clinical practice recommendations for health care providers who care for PWH.
| Type: | Article |
|---|---|
| Title: | Antithrombotic Treatment in Patients With Hemophilia: an EHA-ISTH-EAHAD-ESO Clinical Practice Guidance |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/HS9.0000000000000900 |
| Publisher version: | https://doi.org/10.1097/HS9.0000000000000900 |
| Language: | English |
| Additional information: | This is an open access article distributed under the Creative Commons Attribution-No Derivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Hematology, DIRECT ORAL ANTICOAGULANTS, TRANSIENT ISCHEMIC ATTACK, LEFT ATRIAL APPENDAGE, MAJOR ORTHOPEDIC-SURGERY, FACTOR-VIII DEFICIENCY, THROMBIN GENERATION, CARDIOVASCULAR-DISEASE, BISPECIFIC ANTIBODY, EMICIZUMAB PROPHYLAXIS, VENOUS THROMBOSIS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10172590 |
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