7^th World Hematologists Congress

Biography

Biography: Jean-Francois Schved

Abstract

With the well-known increase of the life expectancy in patients with hemophilia (PWH), patients are faced with age-related comorbidities. Thus, over the last few years, hematologists appear to be witnessing an increase in the frequency of cardiovascular diseases, mainly ischemic cardiopathies or atrial fibrillation. These diseases raise major difficulties in PWH while the recommended treatments rely on antiplatelet agents and anticoagulants. Anticoagulants and antiplatelet treatments increase the risk of bleeding in hemophiliacs and cardiovascular interventions commonly complicate bleeding. To minimize these risks, the clotting factor deficiency needs to be adapted. To get more information on the possibility of treatment, we launched an observational study called COCHE (comorbidity of cardiovascular origin in hemophilia) including PWH treated for atrial fibrillation or ischemic cardiopathies. Some patients underwent endovascular procedures, the minimal follow-up being two years. From these data, it appears that anti-platelet agents can be used with caution and under certain conditions in most hemophiliacs. Invasive cardiovascular interventions are possible and anticoagulants treatments or dual anti-platelet therapy can often be used. In all cases, close collaboration between the cardiologist and hematologist is necessary to offer the patient an optimum treatment.