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January 30, 2017Scientific ReportsOpen Access

Addition of vWF to CHA2DS2-VASc statistically improved predictive value based on IDI and NRI but not c-indexes; addition to HAS-BLED improved c-index but not IDI/NRI, with minimal net benefit on Decision Curve Analysis.

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Why the study?

Does the addition of von Willebrand factor to current risk stratification scores improve event-risk prediction in anticoagulated patients with non-valvular atrial fibrillation?

Population

1215 consecutive outpatients with anticoagulated non-valvular atrial fibrillation, age 76 years, 49% male.

Comparison

Addition of von Willebrand factor measurement to… vs Clinical risk stratification schemes alone

Design

Cohort

Follow-up

almost 7 years

Authors

AGAmaya García-FernándezVRVanessa RoldánJRJosé Miguel Rivera‐Caravaca

Discussion

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Overview

Minimal net benefit precludes routine vWF addition to AF scores; extends associations but leaves clinical utility open pending validation.

Structured PICO

Does the addition of von Willebrand factor to current risk stratification scores improve event-risk prediction in anticoagulated patients with non-valvular atrial fibrillation?

P
Population
1215 consecutive outpatients with anticoagulated non-valvular atrial fibrillation, age 76 (71-81) years, 49% male.
I
Intervention
Addition of von Willebrand factor (vWF) measurement to clinical risk stratification schemes (CHA2DS2-VASc and HAS-BLED)
C
Comparator
Clinical risk stratification schemes alone (CHA2DS2-VASc and HAS-BLED)
O
Outcome
Predictive accuracy for thrombotic/cardiovascular events, major bleeding, and mortalityhard clinical

While von Willebrand factor is associated with adverse outcomes in anticoagulated AF patients, its addition to standard risk scores provides marginal absolute improvements in risk prediction and clinical decision-making.

Cite This Study

García-Fernández et al. (2017) studied this question.

synapsesocial.com/papers/6a0f452dda154484189bc809https://doi.org/10.1038/srep41565
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic value of von Willebrand factor for patients with atrial fibrillation: a meta-analysis of prospective cohort studies2019 · 9 citations
  2. 2Additive Role of Plasma von Willebrand Factor Levels to Clinical Factors for Risk Stratification of Patients With Atrial Fibrillation2006 · 156 citations
  3. 3Prognostic value of von Willebrand factor in patients with atrial fibrillation2018 · 16 citations
  4. 4The role of estimation of plasma von Willebrand factor concentration in stroke risk stratification in patients with atrial fibrillation2022 · 1 citations
  5. 5Predictive value of von Willebrand factor for venous thrombosis in patients with chronic heart failure complicated with atrial fibrillation after anticoagulant therapy2023 · 2 citations