Key result
On-demand hemophilia A treatment shows no significant difference in subclinical cardiac disease by A-ECG vs controls.
Why the study?
Patients with hemophilia A can achieve normal life expectancy and experience coronary artery disease, but the likelihood of subclinical CAD, global hemostasis, and extracellular vesicles in those treated on-demand remains uncharacterized.
Does congenital hemophilia A treated on-demand alter the likelihood of subclinical coronary artery disease or levels of extracellular vesicles compared to age-matched controls?
Case-Control (n=79)
No
Does congenital hemophilia A treated on-demand alter the likelihood of subclinical coronary artery disease or levels of extracellular vesicles compared to age-matched controls?
Patients with hemophilia A treated on-demand exhibit similar subclinical cardiac disease probability on A-ECG as healthy controls, suggesting they may not be protected against coronary artery disease development despite their hypocoagulable state.
Answers are grounded in this paper and cite their sources.
Similar subclinical CAD likelihood in on-demand hemophilia A versus controls; hypothesis-generating for EV contributions to cardiovascular risk.
IntroductionPatients with hemophilia A (HA) can reach normal life expectancy and suffer from coronary artery disease (CAD). The study evaluates the likelihood of subclinical CAD evaluated by advanced electrocardiography (A-ECG), global hemostasis and extracellular vesicles (EVs) in Chinese patients with HA treated on-demand.Materials and MethodsPatients with HA (n = 42) and age-matched male controls (n = 37) were included. The likelihood of having CAD was evaluated by A-ECG. Fibrin formation and fibrinolysis were assessed by the overall hemostatic potential (OHP) assay. EVs derived from platelets (PEVs), endothelial cells (EEVs) and leukocytes (LEVs), and expressing phosphatidylserine (PS + EVs), tissue factor (TF + EVs) or P-selectin (CD62P + EVs) were measured by flow cytometry.ResultsThe likelihood of CAD evaluated by A-ECG did not differ between patients and controls. Fibrin formation and clot stability were significantly impaired in patients. Patients had higher PEVs and CD62P + EVs. CD62P + EVs counts were inversely correlated with OHP, velocity and clot lysis time. Subclinical CAD did not correlate with OHP or EVs.ConclusionControls and patients with HA treated on-demand exhibited no differences in A-ECG, but varied in fibrin formation and clot stability. Larger studies are required to explore the significance of this finding in the context of CAD risk in this population.
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Zong et al. (2026) conducted a case-control in Hemophilia A (n=79). Hemophilia A treated on-demand vs. Healthy age-matched male controls was evaluated on Probability of cardiac disease evaluated by advanced electrocardiography (A-ECG) score (p=0.204). Patients with hemophilia A treated on-demand showed no significant difference in the probability of subclinical cardiac disease by A-ECG compared to controls.
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