The Cardioprotective Potential of von Willebrand Disease in Ischemic Heart Disease

Abstract

von Willebrand factor (vWF) aids coagulation at sites of vessel injury. Elevated vWF levels have been associated with an increased risk of ischemic heart disease (IHD); however, it is unclear whether vWF deficiency, seen in patients with von Willebrand disease (vWD), protects people against IHD. We determined and compared the prevalence and risk of IHD in patients with versus without vWD by using data from the National Inpatient Sample (2009–2014), excluding patients younger than 18 and older than 75 years. The primary outcome was the odds ratio (OR) of IHD in patients with versus without vWD. Secondary outcomes were major medical comorbidities and demographic characteristics in patients with vWD. Of 224,475,443 weighted hospital-discharge samples, we identified 82,809 patients with a vWD diagnosis. The odds of IHD were lower in patients with vWD than in those without (OR=0.54; 95% CI, 0.52–0.56). After multivariable logistic regression analysis and adjustment for age, sex, and typical IHD risk factors (hypertension, smoking, diabetes, hyperlipidemia, chronic kidney disease, obesity, and family history of IHD), the likelihood of IHD remained lower in patients with vWD than in patients without (OR=0.65; 95% CI, 0.63–0.67). Our study shows that vWF deficiency, as seen in patients with vWD, is associated with a decreased prevalence of IHD. Further investigation may confirm these findings.

The relative risk of ischemic cerebrovascular accident in patients with Von Willebrand disease

“…20 Somewhat similar to ours, a study by Mihyawi et al hinted at a protective effect of having vWD, by highlighting a significantly lower odds of ischemic heart disease in patients with vWD compared with those without vWD. 21 Our study did not control for the subjects' blood group, which is an important determinant of vWF levels. Individuals with blood group O have lower plasma levels of circulating vWF compared with the non-O blood groups.…”

“…20 Somewhat similar to ours, a study by Mihyawi et al hinted at a protective effect of having vWD, by highlighting a significantly lower odds of ischemic heart disease in patients with vWD compared with those without vWD. 21…”

Nanobodies as Diagnostic and Therapeutic Tools for Cardiovascular Diseases (CVDs)

“…Different CVDs, such as aortic stenosis, hypertrophic obstructive cardiomyopathy, or congenital structural diseases can generate high shear stress in the bloodstream, leading to the excessive cleavage of VWF multimers, known as acquired von Willebrand syndrome [ 51 ]. VWF is known to contribute to atherosclerosis and is associated with an increased risk of coronary heart disease and ischemic stroke [ 52 ]. In patients with pre-existing vascular disease, VWF is predictive of adverse cardiac events, including death.…”