Abstract W P392: Incidence Of Ischemic Or Hemorrhagic Non-fatal Strokes In Hemophiliac Adults And Teenage Children
Background: Persons with hemophilia are at high risk for spontaneous or prolonged bleeding, including intracranial hemorrhage. However, the incidence of ischemic or hemorrhagic stroke has not been studied in hemophiliac adults and teenage children.
Methods: We analyzed data from the Second Multicenter Hemophilia Cohort Study (MHCS-II) that enrolled patients ≥13 years who had a congenital coagulation disorder [hemophilia A or B (congenital factor VIII or IX deficiency), von Willebrand's disease, or other], and who had serological or molecular evidence of HCV or HIV-1 infection. Participant’s medical history (including factor concentrate use), a targeted physical examination, and blood tests were performed at baseline and annually for three to four years. Person-years were estimated from the date of follow-up (the first blood sample) to the date of an event of interest (stroke), death, or censoring. We use Kaplan Meier analysis to estimate the probability of stroke or death in the study cohort.
Results: A total of 2569 hemophiliac persons (age range = 13-88 years, men n=2431 (94.8%)) were recruited at 52 collaborating hemophilia centers in North and South America and Europe. The severity of hemophilia was classified as mild (>5%) (n=511, 19.9%), moderate (1-5%) (n=490, 19.1%) and severe (<1%) (n=1561, 60.9%) based on von Willebrand Type (type 1,2,3 respectively). A total of 1996 (77.8%) and 584 (22.8%) had received transfusions with factor VII and factor IX, respectively. A total of 4 participants developed stroke (including 1 intracerebral hemorrhage) over 4.5 year’s follow-up period with an estimated incidence of 0.034 per person 100 years.
Conclusions: The rate of stroke appears to be low in adults and teenage children in a cohort of hemophiliacs with predominantly moderate and severe disease.
Author Disclosures: C. Bezzina: None. A.A. Malik: None. A.I. Qureshi: None.
- © 2015 by American Heart Association, Inc.