Von Willebrand factor and risk of ischemic stroke

Abstract

We carried out a case-control study to determine whether von Willebrand factor (vWF) antigen (and factor VII and tissue plasminogen activator [tPA] antigens) are associated with ischemic stroke. Ninety-five patients with transient ischemic attack or minor ischemic stroke recruited from the Oxfordshire Community Stroke Project and one neurology clinic were compared with 236 controls, group-matched for age and sex, from the same general practitioners as the incident cases. In crude analyses, concentrations of vWF antigen were significantly higher in cases than in controls (p = 0.004). The age- and sex-adjusted odds ratios from lowest (referent) to highest quartile of vWF antigen were 1.00, 1.15, 2.34, and 2.36 (trend test, p = 0.006). Factor VII antigen and tPA antigen were not significantly different between cases and controls. Although adjustment for other potential risk factors abolished the statistical significance of the association between vWF and disease, this was largely due to the influence of history of ischemic heart disease. We conclude that vWF is a potent and independent risk factor for transient ischemic attack, minor ischemic stroke, and, by extrapolation, ischemic stroke in general. The data also suggest that vWF may be a risk factor for both ischemic stroke and ischemic heart disease. We found no evidence to implicate factor VII and tPA as risk factors for ischemic stroke.

Migraine and Biomarkers of Endothelial Activation in Young Women

“…20 This procoagulatory protein has been associated with each major cardiovascular risk factor, 21,22 as well with stroke in clinic and community-based longitudinal studies. 23,24 The literature on vWF in migraine is sparse. [25][26][27] We had previously found that migraineurs with prior stroke had higher vWF antigen levels than did migraineurs without stroke.…”

Partial amino acid sequence of purified von Willebrand factor–cleaving protease

“…On the other hand, increased levels of vWF, which may be the result of chronic endothelial cell injury, have been associated with atherogenesis, 2 deep vein thrombosis, 3 myocardial infarction, 4,5 and ischemic stroke. 5,6 Therefore, vWF has been proposed as a target for antithrombotic treatment. 7,8 After secretion into plasma, vWF multimers undergo proteolytic degradation; the 250-kd polypeptide subunits are degraded to fragments of 140, 176, and 189 kd 9 by proteolytic cleavage of the peptide bond Tyr842-Met843.…”

Fibrin D-Dimer, Tissue-Type Plasminogen Activator, von Willebrand Factor, and Risk of Incident Stroke in Older Men

“…4 The von Willebrand factor (vWF) is synthesized primarily by vascular endothelial cells and promotes platelet adhesion and aggregation, leading to thrombus formation. 1 Increased levels of vWF in stroke patients have been reported in several case-control studies, [5][6][7][8] but prospective studies have been inconsistent, with some showing a positive relationship 9,10 and others showing no relationship [11][12][13][14] between vWF and stroke risk. Fibrin D-dimer is the primary degradation product of cross-linked fibrin and is a marker of activated coagulation and fibrinolysis.…”