PB0538 - Comorbidities of cardiovascular diseases and cancer in patients with coagulopathies older than 45 years-old: Review of a Hemophilia Reference Center

Background: In the last two decades there have been great advances in the care of patients with coagulopathies (PWC), which has significantly increased life expectancy, similar to the unaffected population. Thus, a greater number of PWC develop age-related comorbidities, such as cancer and cardiovascular diseases. The latter represent a challenge because management involves a careful balance between thrombotic and hemorrhagic risk, due to the use of antiplatelet and/or anticoagulant drugs. There is currently a lack of evidence from clinical trials, and most guidelines are based primarily on expert opinion.

Aims: Review of the experience on the epidemiology of cardiovascular events and cancer in PWC in a hemophilia treatment reference center.

Methods: Descriptive, retrospective and single-center study of PWC over 45 years-old. The different comorbidities, cardiovascular events, the need for treatment (including antithrombotic medication), oncological diseases and death were reviewed.

Results: 148 patients, with median age was 58 (45-93) years. 66.2% were male and 22.8% female. The majority of patients (34.46%) had haemophilia A followed by von Willebrand disease (31.75%) (Table 1). 9.46% had 4 or more cardiovascular comorbidities. 8.11% presented coronary artery disease requiring stenting with antiplatelet therapy in a short period of time, half of them with prophylaxis at the time of the cardiovascular event. 4.05% had cerebral events, most frequently haemorrhagic. Other cardiovascular events such as aneurysms, valvulopathies or cardiomyopathy occurred in 8.78%. 22.3% developed neoplasms, the most frequent being haematological, followed by genitourinary, with no relation to the type of associated coagulopathy (Table 2). 7 patients died, 3 due to cardiac events and 2 due to progression of their cancer.

Conclusion(s): Oncological diseases and cardiovascular disease risk factors and events are relatively common in PWC. PWC require safe treatment for CVD events, requiring procedures similar to those of the unaffected population. More studies are necessary to establish specific protocols in this population.