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

Robert Klamroth, Cihan Ay, Philippe De Moerloose, Pierre Fontana, Jerzy Windyga, Jan Astermark, Erik Berntorp, Manuela Carvalho, Gerard Dolan, Cedric Hermans, Pål Andre Holme, Gili Kenet, Maria Elisa Mancuso, Natascha Marquardt, Ramiro Nunez, Ingrid Pabinger, Ryan Rodgers, Paul van der Valk, Victor Jimenez Yuste, Irena Preložnik Zupan

Forskningsoutput: TidskriftsbidragÖversiktsartikelPeer review

Sammanfattning

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.

Originalspråkengelska
Sidor (från-till)21-32
TidskriftHaemophilia
Volym29
Nummer1
DOI
StatusPublished - 2023

Ämnesklassifikation (UKÄ)

  • Hematologi

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