|
A coagulação tem um importante papel nas doenças cardiovasculares isquêmicas (DCIs). Existe a hipótese de que a diminuição da coagulabilidade poderia proteger contra essas doenças. Em recente estudo realizado na Holanda e publicado no Lancet, investigou-se a taxa de mortalidade por DCIs em mães de pacientes hemofílicos, as quais podem apresentar coagulabilidade reduzida sem sintomas clínicos.
Foi estudada uma coorte de 1012 mães de pacientes hemofílicos na Holanda. Comparando-se com a população feminina em geral, a taxa de mortalidade era 22% menor. A taxa de mortalidade por DCIs foi reduzida em 36%. Não foi observada redução na taxa de mortalidade por AVC (isquêmico e hemorrágico combinados).
As mulheres pertencentes à coorte apresentavam um risco aumentado para óbito por hemorragia extracraniana; no entanto, o número de óbitos por esta causa foi significativamente menor que a mortalidade por DCIs. Os pesquisadores afirmam que uma diminuição moderada da coagulabilidade tem um efeito protetor contra a doença cardíaca isquêmica.
Decreased mortality of ischaemic heart disease among carriers of haemophilia - Lancet
Abstract
Background Coagulation plays an important part in ischaemic cardiovascular disease. Results of studies have shown that extremes in hypocoagulability protect against ischaemic cardiovascular disease. We have investigated overall mortality and death from cardiovascular causes in carriers of haemophilia, who in most cases have mildly decreased coagulability without clinical signs.
Methods We followed-up a cohort of 1012 mothers of all known people with haemophilia in the Netherlands from birth to death, or the end-of-study date (41 984 person years of follow-up). We obtained vital status and causes of death, if deceased, and compared overall and cause-specific mortality in our cohort with that in the general Dutch female population adjusted for age and calendar period by calculating the standardised mortality ratio (SMR).
Findings Overall mortality was reduced by 22% (261 observed deaths, 333·74 expected; SMR 0·78 [95% CI 0·69–0·88]). Deaths from ischaemic heart disease were reduced by 36% (39 observed deaths, 60·53 expected; SMR 0·64 [0·47–0·88]). We did not note decreased mortality for cerebral stroke (ischaemic and haemorrhagic combined) (28 observed deaths, 36·82 expected; SMR 0·76 [0·53–1·10]). A separate analysis of these two types of stroke was not possible. Women in our cohort had an increased risk of death from extracranial haemorrhage (5 observed deaths, 0·18 expected; SMR 27·78 [8·49–58·18]); however, the number of deaths from this cause was much lower than that for ischaemic heart disease.
Conclusion The results show that a mild decrease in coagulability has a protective effect against fatal ischaemic heart disease.
|
Affiliations
a Department of Clinical Epidemiology, Leiden University Medical Center, Netherlands.
b Haemostasis and Thrombosis Research Centre, Leiden University Medical Center, Netherlands.
 * Correspondence to: Prof F R Rosendaal, Department of Clinical Epidemiology, C9-P, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, Netherlands
IMPORTANTE
- Procure o seu médico para diagnosticar doenças, indicar tratamentos e receitar remédios.
- As informações disponíveis no site da Dra. Shirley de Campos possuem apenas caráter educativo.
|
Search for articles: 
