Sonneveld Michelle A H, Cheng Jin M, Oemrawsingh Rohit M, de Maat Moniek P M, Kardys Isabella, Garcia-Garcia Hector M, van Geuns Robert-Jan, Regar Evelyn, Serruys Patrick W, Boersma Eric, Akkerhuis K Martijn, Leebeek Frank W G
Prof. Frank W. G. Leebeek, MD, PhD, Erasmus University Medical Center, Department of Hematology, Room Na-823, P. O. Box 2040, 3000 CA Rotterdam, The Netherlands, Tel.: +31 10 703 16 72, Fax: +31 10 703 58 14, E-mail:
Thromb Haemost. 2015 Mar;113(3):577-84. doi: 10.1160/TH14-07-0589. Epub 2014 Dec 4.
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.
血管性血友病因子（VWF）血浆水平升高与冠状动脉疾病风险增加相关。有人提出，VWF水平升高部分归因于内皮功能障碍和动脉粥样硬化。我们的目的是研究冠状动脉斑块负荷、通过血管内超声虚拟组织学（IVUS-VH）测量的高危冠状动脉病变的存在与VWF水平之间的关联。此外，我们研究了VWF水平与一年心血管结局之间的关联。2008年至2011年期间，对581例因急性冠状动脉综合征（ACS）（n = 318）或稳定型心绞痛（SAP）（n = 263）接受冠状动脉造影的患者进行了非罪犯冠状动脉的IVUS-VH成像。在冠状动脉造影前采集动脉血样。使用酶联免疫吸附测定法（ELISA）测量VWF抗原（VWF:Ag）水平（n = 577）。ACS患者的VWF:Ag水平显著高于SAP患者（中位数1.73 IU/ml [四分位间距1.27 - 2.31] 对比1.26 IU/ml [0.93 - 1.63]，p < 0.001）。在SAP患者中，高冠状动脉斑块负荷与较高的VWF:Ag水平相关（β = 0.12，p = 0.027），但在ACS患者中并非如此。在ACS患者中，VWF:Ag水平与1年主要不良心血管事件相关（lnVWF:Ag每标准差增加的风险比为4.14，95%置信区间1.47 - 11.6），而在SAP患者中，VWF:Ag水平可预测1年全因死亡和ACS住院（风险比7.07，95%置信区间1.40 - 35.6）。总之，在接受冠状动脉造影的SAP患者中，冠状动脉斑块负荷与VWF:Ag水平相关。在ACS和SAP患者中，高VWF水平可预测一年随访期间的不良心血管结局和死亡。
