VPB0693 - First year report of the multicenter prospective cohort study on ischemic events in adult patients with hemophilia (ADVANCE Japan)

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Azusa Nagao, MD, MSc

MD
Department of Blood Coagulation, Ogikubo Hospital, Tokyo, Japan
Tokyo, Tokyo, Japan

Co-Author(s)

YC

Yushi Chikasawa

Physician
Tokyo Medical University
Tokyo, Tokyo, Japan
AS

Akihiro Sawada

MD
Department of Respiratory Medicine and Hematology, Hyogo Medical University, Hyogo, Japan
Hyogo, Hyogo, Japan
TK

Takeshi Kanematsu

Physician
Nagoya University Hospital
Nagoya, Aichi, Japan
NY

Naoya Yamasaki

Physician
Hiroshima University hospital
Hiroshima, Hiroshima, Japan
HT

Hideyuki Takedani

Head of department
IMSUT Hospital of the Institute of Medical Science, the University of Tokyo
Minatoku, Tokyo, Japan
MN

Masanori Nojima

Physician
IMSUT Hospital, The Institute of Medical Science
Tokyo, Tokyo, Japan
TF

Teruhisa Fujii

Associate Professor
Division of Transfusion Medicine/Hemophilia Treatment Center, Hiroshima University Hospital, Hiroshima, Japan
Hiroshima, Hiroshima, Japan
NS

Nobuaki Suzuki

Service Lecturer
Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan
Nagoya, Aichi, Japan
TM

Tadashi Matsushita

Professor
Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan.
Nagoya, Aichi, Japan
SH

Satoshi Higasa

Medical Director
Department of Hematology, Hyogo College of Medicine Hospital, Nishinomiya, Japan
Nishinomiya, Hyogo, Japan
KA

Kagehiro Amano

Professor
Department of Laboratory Medicine, Tokyo Medical University
Tokyo, Tokyo, Japan
TS

Takashi Suzuki

Head of department
ogikubo hospital
tokyo, Tokyo, Japan

Background: Although advancements in treatment have extended the life expectancy of patients with hemophilia, age-related complications, including cardiovascular disease (CVD), have become a rising concern. In 2016, we conducted a retrospective study on 711 patients with hemophilia and observed that only 2 patients experienced myocardial infarction.

Aims: We initiated a multicenter prospective cohort study in 2019 for investigating the incidence and treatment status of CVD, lifestyle-related diseases, malignancies, and other parameters in Japanese patients with hemophilia (Fig 1). The preliminary data obtained from the first year of the study are presented herein.

Methods: Patients with congenital hemophilia A/B, aged ≥ 40 years, will be included in the study, which aims to enroll 600 patients, to be followed-up for 10 years.

Results: As of December 2019, 286 patients with hemophilia were enrolled from 13 centers. Their median age was 51.0 years (range 40–89), and 86.0% and 14.0% of patients had hemophilia A and B, respectively. Breakdown of disease severity revealed that 69.2%, 13.6%, and 17.1% of patients had severe, moderate, and mild disease, respectively, and 74.8% of patients received prophylaxis. Past medical history revealed that 4 patients experienced cerebral infarction. Analysis of the ischemic events in 2019 revealed 1, 1, and 2 cases of angina pectoris, transient ischemic attack, and atherosclerosis obliterans, respectively. Three patients were on antiplatelet therapy. The prevalence of comorbidities and risk factors is depicted in Fig 2. The median QRISK3 and Suita scores were 7.1 (interquartile range [IQR]: 4.2–13.8) and 42 (IQR: 35–46), respectively.

Conclusion(s): Four cases with CVD complications were registered in the first preliminary report. Based on QRISK3 and Suita scores during registration, there is a concern about the possible development of CVD within 10 years, which highlights the importance of continual registration and analyses of such cases.