Oral anticoagulation in patients with atrial fibrillation was associated with significantly lower vWF plasma levels (133.50 vs 154.00 UI/dL, P < .001) and vWF activity compared to no anticoagulation.
Observational (n=107)
Does oral anticoagulation reduce vWF levels and activity in patients with atrial fibrillation?
Oral anticoagulation is associated with reduced vWF levels and activity in patients with atrial fibrillation, which may reflect a lower risk of thrombotic events.
Absolute Event Rate: 133.5% vs 154%
p-value: p=<.001
von Willebrand factor (vWF) is a multimeric glycoprotein present in blood plasma. It is synthesized in megakaryocytes and endothelial cells, secreted into circulation in the form of high-molecular-weight multimers (HMWMs), and cleaved into shorter, less active multimers by ADAMTS13. It is essential for platelet adhesion and aggregation. Previous studies have investigated the relationship between vWF levels and thromboembolic events with little regard to vWF multimeric structure. Patients with atrial fibrillation (AF) exhibit higher plasma vWF and lower ADAMTS13 levels. One hundred seven patients with AF, 51 anticoagulated and 56 nonanticoagulated, were eligible for the study. Plasma samples were analyzed for vWF antigen, vWF activity, and ADAMTS13; vWF multimers were analyzed by Western blot in 1% to 1.3% sodium dodecyl sulfate agarose gel electrophoresis. Patients with AF without oral anticoagulation (OAC) had significantly higher vWF plasma levels (154.00 75-201 UI/dL) and vWF activity (60.00% 20%-210%) compared to patients with OAC (133.50 90-192 UI/dL, P = <.001; 50.00% 20%-160%, P = .02). Both were specially decreased in patients treated with acenocumarin. Patients without OAC also showed lower ADAMTS13 levels and presence of vWF HMWMs. Patients with AF show higher plasma levels and vWF activity. Moreover, treatment with traditional OAC (acenocumarin) significantly reduced vWF levels. Patients without OAC might have an increased risk of thrombotic events showing lower ADAMTS13 and higher vWF levels. Patients with stroke had higher plasma levels, vWF activity, and HMWMs. Our study suggests that increased vWF levels and presence of HMWMs could be related to cerebrovascular disease and may represent useful biomarkers for stroke in AF.
Castañeda et al. (Thu,) conducted a observational in Atrial Fibrillation (n=107). Oral anticoagulation (OAC) vs. No oral anticoagulation was evaluated on vWF plasma levels (UI/dL) (p=<.001). Oral anticoagulation in patients with atrial fibrillation was associated with significantly lower vWF plasma levels (133.50 vs 154.00 UI/dL, P < .001) and vWF activity compared to no anticoagulation.