Von Willebrand factor in relation to coronary plaque characteristics and cardiovascular outcome

Abstract

High von Willebrand factor (VWF) plasma levels are associated with an increased risk of coronary artery disease. It has been suggested that the increase of VWF levels is partly due to endothelial dysfunction and atherosclerosis. Our aim was to investigate the association between coronary plaque burden, the presence of high-risk coronary lesions as measured by intravascular ultrasound virtual histology (IVUS-VH) and VWF levels. In addition, we studied the association between VWF levels and one-year cardiovascular outcome. Between 2008 and 2011, IVUS-VH imaging of a non-culprit coronary artery was performed in 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) (n= 318) or stable angina pectoris (SAP) (n= 263). Arterial blood was sampled prior to the coronary angiography. VWF antigen (VWF:Ag) levels were measured using ELISA (n= 577). Patients with ACS had significantly higher VWF:Ag levels than SAP patients (median 1.73 IU/ml [IQR 1.27-2.31] vs 1.26 IU/ml [0.93-1.63], p< 0.001). High coronary plaque burden was associated with higher VWF:Ag levels (β= 0.12, p=0.027) in SAP patients, but not in ACS patients. In ACS patients, VWF:Ag levels were associated with 1-year MACE (HR 4.14 per SD increase of lnVWF:Ag, 95 % CI 1.47-11.6), whereas in SAP patients VWF:Ag levels predicted 1-year all-cause death and hospitalisation for ACS (HR 7.07 95 % CI 1.40-35.6). In conclusion, coronary plaque burden was associated with VWF:Ag levels in SAP patients undergoing coronary angiography. In ACS and SAP patients, high VWF levels are predictive of adverse cardiovascular outcome and death during one-year follow-up.

Combined use of an electrostatic precipitator and a high-efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults

“…[17] Myocardial oxygen supply relative to demand was evaluated with the subendocardial viability ratio (SEVR). [18] Finally, plasma sCD62P and von Willebrand factor (VWF) were evaluated as biomarkers of platelet activation[19] and endothelial cell dysfunction,[20] respectively.…”

The Role of von Willebrand Factor in Vascular Inflammation: From Pathogenesis to Targeted Therapy

“…In the European Concerted Action on Thrombosis and Disabilities (ECAT) study [80], in stable patients with angiographically documented coronary artery disease (CAD), higher levels of VWF:antigen (VWF:Ag) were independently associated with an increased incidence of MI and sudden death. More recently, in the ATHEROREMO-IVUS study [81], in patients with stable CAD (SCAD), an increased level of VWF:Ag was associated with higher coronary plaque burden, adverse CV outcome, and death during 1-year of follow-up. VWF is also an independent risk factor for first STEMI: levels of VWF are significantly increased in patients with first ST-elevation myocardial infarction (STEMI) rather than in controls [82].…”

Review of biomarkers to assess the effects of switching from cigarettes to modified risk tobacco products

“…Several studies in initially healthy subjects showed rather weak associations between vWF levels and CVD risk that did not always reach statistical significance. This association becomes much stronger in patients with pre-existing vascular disease, particularly survivors of myocardial infarction (MI) and patients with type 1 and 2 diabetes (Sadler 1998, Franchini and Lippi 2007, Spiel et al 2008, and the association between vWF levels and cardiovascular risk was found to be stronger in smokers compared to non-smokers (Lip and Blann 1995, Blann et al 1997a, Whincup et al 2002, Blann 2006, Vischer 2006, Franchini and Mannucci 2008, Frankel et al 2008, Spiel et al 2008, Paulinska et al 2009, van Galen et al 2012, Lenting et al 2013, Sonneveld et al 2015. Evidence for an association between elevated blood levels of vWF and respiratory diseases is rather limited, and no significant correlation between serum vWF levels and subsequent decline in FEV 1 was found, indicating that vWF is not a suitable predictor for increased risk of accelerated decline in FEV 1 (O'Callaghan et al 2005).…”