Applicability of the European Society of Cardiology Guidelines on the management of acute coronary syndromes to older people with haemophilia A - A modified Delphi consensus by the ADVANCE Working Group.

Autor: Klamroth R; Vivantes Klinikum im Friedrichshain, Berlin, Germany., Ay C; Department of Medicine I, Clinical Division of Haematology and Haemostaseology, Medical University of Vienna, Vienna, Austria., De Moerloose P; Faculty of Medicine, Geneva, Switzerland., Fontana P; Division of Angiology and Hemostasis, University Hospitals of Geneva, Geneva, Switzerland., Windyga J; Department of Hemostasis Disorders and Internal Medicine, Institute of Hematology and Transfusion Medicine, Warsaw, Poland., Astermark J; Skåne University Hospital, Malmö, Sweden., Berntorp E; Lund University, Malmö, Sweden., Carvalho M; Congenital Coagulopathies Reference Center, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal., Dolan G; St Thomas' Hospital, London, United Kingdom., Hermans C; St-Luc University Hospital, Brussels, Belgium., Holme PA; Oslo University Hospital, Oslo, Norway., Kenet G; Sheba Medical Center, Tel Hashomer & The Amalia Biron Thrombosis Research Institute, Tel Aviv University, Israel., Mancuso ME; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Marquardt N; Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany., Nunez R; Virgen del Rocío Hospital, Seville, Spain., Pabinger I; Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria., Rodgers R; Glasgow Royal Infirmary, Glasgow, UK., Valk PV; Van Creveldkliniek, University Medical Center Utrecht, Utrecht, University of Utrecht, The Netherlands., Yuste VJ; Hospital Universitario La Paz, Autónoma University, Madrid, Spain., Zupan IP; University Medical Centre Ljubljana, Department of Haematology, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
Jazyk: angličtina
Zdroj: Haemophilia : the official journal of the World Federation of Hemophilia [Haemophilia] 2023 Jan; Vol. 29 (1), pp. 21-32. Date of Electronic Publication: 2022 Oct 21.
DOI: 10.1111/hae.14674
Abstrakt: Introduction: As people with haemophilia (PWH) receive better treatment and live longer they are more likely to encounter cardiovascular disease (CVD) and other comorbidities. ESC guidelines for the acute management of patients presenting with acute coronary syndrome (ACS) are based on the non-haemophilia population.
Aim: To review the guidelines and propose relevant adaptations for PWHA without inhibitors who are treated with prophylaxis and present with ACS.
Methods: As part of the ADVANCE Group, 20 European haemophilia experts used a modified Delphi approach to develop and gain consensus on proposed adaptations of the ESC guidelines for PWHA without inhibitors.
Results: Of the 32 Class I recommendations across both guidelines, adaptions were considered necessary and proposed for 15. The adaptions highlight the need to provide sufficient FVIII trough levels at the time of antithrombotic treatment in people with haemophilia A (HA) without inhibitors. Patients receiving emicizumab prophylaxis and requiring oral anticoagulation therapy or combined single antiplatelet plus oral anticoagulation therapy will require additional FVIII replacement therapy.
Conclusion: In the absence of high-quality clinical evidence, the combined expert opinion used to develop these adaptions to the current ESC guidelines may help to guide clinicians in their treatment decisions when a PWHA presents with ACS.
(© 2022 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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