As people with haemophilia (PwH) are ageing, they can develop atherosclerotic cardiovascular disease (ASCVD). Electrocardiograms (ECG) alterations may be a sign of ASCVD in PwH.

To describe the prevalence of resting ECG alterations among asymptomatic PwH.

PwH aged ≥ 30 years participated in the Haemophilia Cardiovascular Risk (HemoCardio) Study. PwH with previous ASCVD event were excluded. Obesity, systemic arterial hypertension, diabetes mellitus, and dyslipidaemia were evaluated. Resting ECG traces were analysed according to universally accepted reference values and the ELSA-Brasil results for asymptomatic Brazilian men. Based on the universal accepted normal values and using the QT index, we further described the altered ECGs as minor or major changes, according to the Minnesota Code.

Sixty-four PwH were included. Median age at study entry was 43.5 years [IQR (interquartile range),35.0-51.8]. Most patients had haemophilia A (81%) and 47% were severe. Prevalence of obesity, SAH, DM, and dyslipidaemia were 16%, 56%, 14%, and 72%, respectively. All the PwH had sinus rhythm, except for one, who had an implanted pacemaker due to idiopathic third-degree atrioventricular block. Altered ECGs were found in 25% and 30% of PwH, according to universal or ELSA-Brasil criteria, respectively. Major changes were found in 8 PwH (13%) according to the Minnesota Code, including 2 ECGs with ischaemia-like wall inactivity.

The prevalence of altered ECG varied from 25% to 30% among asymptomatic PwH. In addition, there was a high prevalence of SAH and dyslipidaemia, but.