Xier Zulipiyemu, Zhu Yu-Xia, Tang Shou-Wei, Kong Can, Aili Dilihumaer, Huojia Guzailinuer, Peng Hui
Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.
Front Cardiovasc Med. 2023 Jan 4;9:1013815. doi: 10.3389/fcvm.2022.1013815. eCollection 2022.
A vital role in coronary artery disease is played by Von Willebrand factor (VWF), which serves as a bridge between platelets and the subendothelial matrix after vessel damage. The purpose of the study was to assess the validity of plasma VWF antigen (VWF: Ag) levels as a predictor of clinical outcomes after acute myocardial infarction (AMI).
Three hundred and seventy-four patients were studied following coronary angiography, including 209 patients suffering from acute myocardial infarction and 165 healthy participants. Coronary angiography was followed by measurement of plasma VWF: Ag levels. Over a 2-year follow-up period, major adverse cardiopulmonary and cerebrovascular events (MACEs) were the primary endpoint. All-cause mortality was investigated as a secondary endpoint.
When compared to controls, patients with AMI had mean plasma VWF: Ag levels that were ~1.63 times higher (0.860 ± 0.309 vs. 0.529 ± 0.258 IU/ml; < 0.001). The plasma VWF: Ag levels were substantially higher in patients who experienced MACEs after myocardial infarction vs. those without MACEs (1.088 ± 0.253 vs. 0.731 ± 0.252 IU/ml; < 0.001). For predicting long-term MACEs using the optimal cut-off value (0.7884 IU/ml) of VWF: Ag, ROC curve area for VWF: Ag was 0.847, with a sensitivity of 87.2% and a specificity of 66.3% (95%CI: 0.792-0.902; = 0.001). Two-year follow-up revealed a strong link between higher plasma VWF: Ag levels and long-term MACEs. At the 2-year follow-up, multivariate regression analysis revealed an independent relationship between plasma VWF: Ag levels and MACEs (HR = 6.004, 95%CI: 2.987-12.070).
We found evidence that plasma VWF: Ag levels were independent risk factors for AMI. Meanwhile, higher plasma VWF: Ag levels are associated with long-term MACEs in people with AMI.
血管性血友病因子（VWF）在冠状动脉疾病中发挥着重要作用，在血管损伤后，它作为血小板与内皮下基质之间的桥梁。本研究的目的是评估血浆VWF抗原（VWF:Ag）水平作为急性心肌梗死（AMI）后临床结局预测指标的有效性。
对374例患者进行冠状动脉造影后研究，其中包括209例急性心肌梗死患者和165例健康参与者。冠状动脉造影后测量血浆VWF:Ag水平。在2年的随访期内，主要不良心肺和脑血管事件（MACE）是主要终点。全因死亡率作为次要终点进行调查。
与对照组相比，AMI患者的血浆VWF:Ag平均水平高出约1.63倍（0.860±0.309 vs. 0.529±0.258 IU/ml；<0.001）。心肌梗死后发生MACE的患者血浆VWF:Ag水平显著高于未发生MACE的患者（1.088±0.253 vs. 0.731±0.252 IU/ml；<0.001）。使用VWF:Ag的最佳截断值（0.7884 IU/ml）预测长期MACE时，VWF:Ag的ROC曲线面积为0.847，敏感性为87.2%，特异性为66.3%（95%CI：0.792-0.902；=0.001）。两年随访显示，较高的血浆VWF:Ag水平与长期MACE之间存在密切联系。在2年随访时，多因素回归分析显示血浆VWF:Ag水平与MACE之间存在独立关系（HR=6.004，95%CI：2.987-12.070）。
我们发现证据表明血浆VWF:Ag水平是AMI的独立危险因素。同时，较高的血浆VWF:Ag水平与AMI患者的长期MACE相关。
