Plasma VWF: Ag levels predict long-term clinical outcomes in patients with acute myocardial infarction.

ABSTRACT

Background: 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). Methods: 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. Results: 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; P < 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; P < 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; P = 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). Conclusion: 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.