Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
Eur J Haematol. 2017 Dec;99(6):569-576. doi: 10.1111/ejh.12975. Epub 2017 Oct 16.
von Willebrand factor (VWF) is an independent risk factor for adverse events in patients with non-valvular atrial fibrillation (NVAF). However, it is unclear if VWF level remains elevated and predictive of stroke during entire course of NVAF.
In order to determine if VWF is a time-dependent blood variable, VWF antigen measured by latex immunoassay in 425 NVAF patients and 100 controls with normal sinus rhythm (NSR) was analyzed according to NVAF duration (<1 month: n = 76, 1-12 months: n = 98, and >12 months: n = 251). The mean VWF antigen level in NVAF patients with <1-month duration (167 ± 59%) was not different compared to those with 1-12 months (157 ± 50%, P = .24) and >12 months duration (156 ± 54%, P = .11) but higher compared to NSR controls (143 ± 48%, P = .003). Higher VWF level correlated with higher CHADS scores and with progressing intensity of blood stasis in the left atrium and thrombus formation in all three time periods of atrial fibrillation duration. Patients not treated with warfarin had VWF 30% higher in the first month compared to following months.
von Willebrand Factor is steadily elevated throughout the course of dysrhythmia in NVAF patients treated with warfarin and in those with higher intensity of left atrium blood stasis.
血管性血友病因子（VWF）是非瓣膜性心房颤动（NVAF）患者不良事件的独立危险因素。然而，目前尚不清楚 VWF 水平是否在 NVAF 整个病程中持续升高并预测中风。
为了确定 VWF 是否是一个时间依赖性的血液变量，我们通过乳胶免疫测定法测量了 425 例 NVAF 患者和 100 例窦性心律正常（NSR）对照者的 VWF 抗原，并根据 NVAF 持续时间（<1 个月：n=76，1-12 个月：n=98，>12 个月：n=251）进行分析。持续时间<1 个月的 NVAF 患者的 VWF 抗原水平（167±59%）与持续时间为 1-12 个月（157±50%，P=0.24）和>12 个月（156±54%，P=0.11）的患者无差异，但高于 NSR 对照组（143±48%，P=0.003）。较高的 VWF 水平与较高的 CHADS 评分以及左心房血瘀强度的进展和血栓形成相关，在房颤持续时间的所有三个时期均如此。未接受华法林治疗的患者在第一个月的 VWF 水平比随后几个月高 30%。
在接受华法林治疗的 NVAF 患者和血瘀强度较高的患者中，VWF 在心律失常的整个病程中持续升高。
