en
Scientific article
Review
English

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

Published inHaemophilia, vol. 29, no. 1, p. 21-32
Publication date2023-01
First online date2022-10-21
Abstract

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.

eng
Keywords
  • Acute coronary syndrome
  • Consensus
  • Guidelines
  • Haemophilia
  • Humans
  • Aged
  • Acute Coronary Syndrome / therapy
  • Acute Coronary Syndrome / drug therapy
  • Hemophilia A / complications
  • Hemophilia A / drug therapy
  • Delphi Technique
  • Cardiology
  • Anticoagulants / therapeutic use
Citation (ISO format)
KLAMROTH, Robert et al. 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. In: Haemophilia, 2023, vol. 29, n° 1, p. 21–32. doi: 10.1111/hae.14674
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Article (Published version)
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ISSN of the journal1351-8216
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Technical informations

Creation05/11/2023 10:54:35 AM
First validation10/02/2023 9:26:21 AM
Update time10/02/2023 9:26:21 AM
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