Zhong Cheng, Xin Minghua, He Lang, Sun Guojian, Shen Farong
Department of Cardiology, Zhejiang Greentown Cardiovascular Hospital, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2018 Jul;97(27):e11269. doi: 10.1097/MD.0000000000011269.
Studies on the prognostic role of von Willebrand factor (vWF) in patients with atrial fibrillation (AF) are conflicting. This meta-analysis aimed to evaluate the association of elevated circulating vWF level with adverse outcomes in patients with AF.
PubMed and Embase were used to search literature through August 2017. Prospective observational studies that evaluated the association of elevated vWF level with major adverse cardiac events (MACEs) and all-cause mortality in patients with AF were deemed eligible. The MACEs included death, stroke/transient ischemic attack, heart failure, myocardial infarction, and systemic/peripheral embolism.
A total of 6 studies were included this meta-analysis. Patients with AF with the highest vWF level were independently associated with greater risk of MACEs (risk ratio [RR] 2.20; 95% confidence intervals [CI] 1.61-3.01) and all-cause mortality (RR 1.63; 95% CI 1.39-1.91). Subgroup analysis showed that the prognostic role of higher vWF level was consistently observed in each defined subgroups.
Patients with AF with elevated vWF level are independently associated with a higher risk of MACEs and all-cause mortality. However, more well-designed prospective studies are needed to confirm these findings.
关于血管性血友病因子（vWF）在心房颤动（AF）患者中的预后作用的研究结果相互矛盾。本荟萃分析旨在评估循环中vWF水平升高与AF患者不良结局之间的关联。
利用PubMed和Embase检索截至2017年8月的文献。评估vWF水平升高与AF患者主要不良心脏事件（MACE）和全因死亡率之间关联的前瞻性观察性研究被认为符合条件。MACE包括死亡、中风/短暂性脑缺血发作、心力衰竭、心肌梗死和全身/外周栓塞。
本荟萃分析共纳入6项研究。vWF水平最高的AF患者与发生MACE的风险更高（风险比[RR]2.20；95%置信区间[CI]1.61 - 3.01）和全因死亡率更高（RR 1.63；95% CI 1.39 - 1.91）独立相关。亚组分析表明，在每个定义的亚组中均一致观察到较高vWF水平的预后作用。
vWF水平升高的AF患者与发生MACE和全因死亡率的较高风险独立相关。然而，需要更多设计良好的前瞻性研究来证实这些发现。
