Schedules of replacement therapy with FVIII or FIX concentrates to reach target factor levels in elderly persons with severe hemophilia during cardiac procedures
| Procedure . | Replacement regimen . | |
|---|---|---|
| Dosage . | Target . | |
| Diagnostic coronary angiography | Bolus infusion of 40 U/kg FVIII (80 U/kg FIX), followed by 20 U/kg FVIII (30 U/kg FIX) after 12 h | Peak factor level ≥ 80 U/dL |
| PCI with bare metal stents | ||
| Before the procedure | Bolus infusion of 40 U/kg FVIII (80 U/kg FIX), followed by 20 U/kg FVIII (30 U/kg FIX) after 12 h | Peak factor level ≥ 80 U/dL |
| During dual antiplatelet therapy with aspirin and clopidogrel | Infusions of 50 U/kg FVIII every other day (60-70 U/kg FIX) for 1 mo | Trough factor levels ≥ 30 U/dL |
| During single antiplatelet therapy with aspirin | Infusions of 25-40 U/kg FVIII every other day or 25-50 U/kg FIX 2-3×/wk for 1 y or indefinitely | Trough factor levels ≥ 5 U/dL |
| Fibrinolysis | Bolus infusion of 40 U/kg FVIII (80 U/kg FIX), followed by continuous infusion (3 U/kg/h FVIII or FIX) or 20 U/kg FVIII (30 U/kg FIX) every 12 h for 48 h | Peak factor levels ≥ 80 U/dL, followed by trough levels ≥ 50 U/dL |
| Procedure . | Replacement regimen . | |
|---|---|---|
| Dosage . | Target . | |
| Diagnostic coronary angiography | Bolus infusion of 40 U/kg FVIII (80 U/kg FIX), followed by 20 U/kg FVIII (30 U/kg FIX) after 12 h | Peak factor level ≥ 80 U/dL |
| PCI with bare metal stents | ||
| Before the procedure | Bolus infusion of 40 U/kg FVIII (80 U/kg FIX), followed by 20 U/kg FVIII (30 U/kg FIX) after 12 h | Peak factor level ≥ 80 U/dL |
| During dual antiplatelet therapy with aspirin and clopidogrel | Infusions of 50 U/kg FVIII every other day (60-70 U/kg FIX) for 1 mo | Trough factor levels ≥ 30 U/dL |
| During single antiplatelet therapy with aspirin | Infusions of 25-40 U/kg FVIII every other day or 25-50 U/kg FIX 2-3×/wk for 1 y or indefinitely | Trough factor levels ≥ 5 U/dL |
| Fibrinolysis | Bolus infusion of 40 U/kg FVIII (80 U/kg FIX), followed by continuous infusion (3 U/kg/h FVIII or FIX) or 20 U/kg FVIII (30 U/kg FIX) every 12 h for 48 h | Peak factor levels ≥ 80 U/dL, followed by trough levels ≥ 50 U/dL |