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. 2021 Sep 24;13(3):9169.
doi: 10.4081/hr.2021.9169. eCollection 2021 Sep 6.

Apixaban and eftrenonacog alfa treatment in a patient with moderate hemophilia B and cardiovascular disease

Rita C Santoro  1 , Mariapia Falbo  1 , Alessandro Ferraro  2
Affiliations

Apixaban and eftrenonacog alfa treatment in a patient with moderate hemophilia B and cardiovascular disease

Rita C Santoro et al. Hematol Rep. .

Abstract

In developed countries, the life expectancy of patients with hemophilia (PwH) is now close to that of the unaffected male population. This means that these patients are at risk of developing age-related comorbidities, including cardiovascular disease. Managing cardiovascular disease in PwH patients can be particularly challenging, due to their high bleeding risk. To our knowledge, this is the first report of a male patient with moderate hemophilia B and hypertensive ischemic heart disease complicated by arrhythmia due to nonvalvular atrial fibrillation, who was treated with apixaban and left atrial appendage closure while receiving concomitant anti-hemorrhagic prophylaxis with eftrenonacog alfa.

Keywords: Apixaban; atrial fibrillation; cardiovascular surgical procedures; factor IX Fc fusion protein; hemophilia B.

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Figures

Figure 1.
Figure 1.
The patient’s treatment timeline for 2019. rFIXFc, eftrenonacog alfa.
Figure 2.
Figure 2.
The patient’s (A) CHA2DS2-VASc score and (B) HAS-BLED score in March 2019. His risk factors are indicated by arrows. ALT, alanine aminotransferase; AP, alkaline phosphatase; AST, aspartate aminotransferase; Cr, creatinine; INR, international normalized ratio; NSAID, non-steroidal anti-inflammatory drug; TIA, transient ischemic attack.
See this image and copyright information in PMC

References

    1. Darby SC, Kan SW, Spooner RJ, et al. . Mortality rates, life expectancy, and causes of death in people with hemophilia A or B in the United Kingdom who were not infected with HIV. Blood 2007;110:815-25. - PubMed
    1. January CT, Wann LS, Calkins H, et al. . 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in collaboration with the Society of Thoracic Surgeons. Circulation 2019;140:e125-51. - PubMed
    1. Schutgens REG, Voskuil M, Mauser-Bunschoten EP. Management of cardiovascular disease in aging persons with haemophilia. Hamostaseologie 2017;37:196-201. - PubMed
    1. Ferraris VA, Boral LI, Cohen AJ, et al. . Consensus review of the treatment of cardiovascular disease in people with hemophilia A and B. Cardiol Rev 2015;23:53-68. - PMC - PubMed
    1. Mannucci PM, Schutgens REG, Santagostino E, et al. . How I treat agerelated morbidities in elderly persons with hemophilia. Blood 2009;114:5256-63. - PubMed

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