Key result
Elevated day 30 vWF:Ag strongly predicts 90-day ischemic events after off-pump CABG with AUC ~0.93.
Why the study?
Do high plasma vWF: Ag levels predict cardiovascular ischemic events in NSTEMI patients after OPCAB surgery?
Cohort (n=203)
No
Do high plasma vWF: Ag levels predict cardiovascular ischemic events in NSTEMI patients after OPCAB surgery?
High plasma vWF: Ag levels postoperatively may serve as a sensitive surrogate marker for predicting cardiovascular ischemic events in NSTEMI patients undergoing OPCAB.
Answers are grounded in this paper and cite their sources.
May stratify post-OPCAB ischemic risk in NSTEMI; hypothesis-generating and requires prospective validation before clinical adoption.
The aim of our study was to determine the characteristics and value of plasma von Willebrand factor antigen (vWF: Ag) levels after off-pump coronary artery bypass grafting (OPCAB) surgery in predicting the risk of cardiovascular ischemic events.A retrospective cohort analysis of 203 non-ST-segment elevation myocardial infarction patients was performed. Patients were divided into a poor recovery group and a stable condition group according to whether ischemic events occurred or not within 90 days postoperatively. The level of vWF: Ag was detected using a blood coagulation analyzer. SPSS17.0 statistical software was used for data analysis. The Friedman rank sum test and Mann-Whitney U test were used for intra-group and inter-group data analysis, respectively. The diagnostic performance of vWF: Ag was evaluated by receiver operating characteristic (ROC) curve analysis.Plasma vWF: Ag levels at postoperative days 14, 30, 60, and 90 in the poor recovery group were significantly higher than those at the corresponding time points in the stable group. The area under the ROC curve in diagnosing adverse events was 0.927 (95% CI: 0.867~0.987) with 96.6% sensitivity and 58.6% specificity when the cut-off value of vWF: Ag was 233% at postoperative day 30.The changing characteristics of plasma vWF: Ag sensitively reflect the degree of vascular endothelial injury of OP-CAB patients and might serve as a surrogate marker of the adverse event of non-ST segment elevation myocardial infarction.
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Men et al. (2015) conducted a cohort in Non-ST-segment elevation myocardial infarction (NSTEMI) (n=203). Plasma von Willebrand factor antigen (vWF: Ag) level vs. Low vWF: Ag level was evaluated on Cardiovascular ischemic events within 31 to 90 days postoperatively (AUC 0.927, 95% CI 0.867-0.987). A plasma vWF: Ag cut-off value of 233% at postoperative day 30 strongly predicted cardiovascular ischemic events within 90 days after off-pump coronary artery bypass grafting with an AUC of 0.927.
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