Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
J Thromb Haemost. 2011 Feb;9(2):275-81. doi: 10.1111/j.1538-7836.2010.04134.x.
Compared with coronary artery disease, there are few studies on von Willebrand factor (VWF) in ischemic stroke (IS). Moreover, there is little information on VWF in the etiologic subtypes of IS.
The aim of the present study was to investigate VWF in IS and in the etiologic subtypes of IS.
PATIENTS/METHODS: The Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) is a case-control study comprising 600 patients and 600 matched controls. Etiologic IS subtype was defined according to the TOAST criteria. Blood sampling was performed in the acute phase and after 3 months.
The levels of VWF were increased in overall IS, at both time-points. The 3-month VWF levels were increased in the subtypes of large-vessel disease (LVD), cardioembolic (CE) stroke and cryptogenic stroke, but not in the subtype of small-vessel disease (SVD), as compared with the controls. The acute phase VWF levels were significantly increased in all four subtypes. In the multivariate regression analysis, with vascular risk factors as covariates, the 3-month VWF levels were associated with CE stroke and cryptogenic stroke, and the acute phase VWF levels with all subtypes. There were significant subtype-specific differences in VWF, with the highest levels in LVD and CE stroke.
The present results show that VWF levels are increased in patients with IS. Furthermore, the VWF levels differ between etiologic IS subtypes and thus, it is important to consider etiologic subtypes in future studies of VWF in patients with IS.
与冠状动脉疾病相比,关于缺血性脑卒中(IS)中血管性血友病因子(VWF)的研究较少。此外,关于 IS 的病因亚型中 VWF 的信息也很少。
本研究旨在探讨 IS 及 IS 的病因亚型中 VWF 的变化。
患者/方法:萨赫林斯卡学院缺血性脑卒中研究(SAHLSIS)是一项病例对照研究,共纳入 600 例患者和 600 例匹配对照。病因学 IS 亚型根据 TOAST 标准定义。在急性期和 3 个月时进行采血。
总体 IS 患者的 VWF 水平在两个时间点均升高。3 个月时,大血管疾病(LVD)、心源性栓塞(CE)卒中和隐匿性卒中亚型的 VWF 水平升高,但小血管疾病(SVD)亚型与对照组相比没有升高。四个亚型的急性期 VWF 水平均显著升高。在多变量回归分析中,以血管危险因素为协变量,3 个月时的 VWF 水平与 CE 卒中和隐匿性卒中相关,而急性期 VWF 水平与所有亚型相关。VWF 存在明显的亚型特异性差异,LVD 和 CE 卒中的水平最高。
本研究结果表明,IS 患者的 VWF 水平升高。此外,VWF 水平在不同病因学 IS 亚型之间存在差异,因此,在未来研究 IS 患者的 VWF 时,考虑病因学亚型很重要。