Published online May 6, 2017. doi: 10.5315/wjh.v6.i2.28
Peer-review started: November 13, 2016
First decision: March 7, 2017
Revised: March 15, 2017
Accepted: April 4, 2017
Article in press: April 7, 2017
Published online: May 6, 2017
Hemophilia A is an X-linked recessive disorder characterized by a deficiency of coagulation factor VIII (FVIII) and therefore by a greater risk of bleeding during percutaneous interventional procedures and during the dual antiplatelet therapy (DAPT) in patients with ischemic heart disease. Information regarding safe percutaneous procedures in hemophiliacs is limited. Since the introduction of FVVIII concentrates, the life expectancy of hemophiliac patients has improved and consequently, the rate of ischemic heart disease in this population is increased. Frequently the replacement therapy can trigger the onset of an acute coronary syndrome. We report a case of a patient with mild Hemophilia A, who presents with unstable angina, treated successfully with coronary angioplasty and drug eluting stent implantation without replacement of FVVIII, treated with long term DAPT without major bleeding after six months of follow up.
Core tip: Hemophilia is a rare condition, but in some cases, could create difficulties in the management of other disease, such as acute coronary syndrome and unstable angina. Data in literature regarding this condition are lacking. This case report would be an example of the management of patients with mild deficit of Factor VIII activity according to the recent consensus.