Key result
Upper quartile VWF-N during COPD exacerbation linked to ~56% higher MACE risk vs lower quartile.
Why the study?
Cardiovascular diseases are common in COPD, potentially due to clot formation and resolution secondary to systemic inflammation, but whether these biomarkers predict major cardiovascular events during acute exacerbations was unclear.
Do biomarkers of clot formation and resolution predict major cardiovascular events in patients with acute exacerbation of COPD?
Cohort (n=299)
Do biomarkers of clot formation and resolution predict major cardiovascular events in patients with acute exacerbation of COPD?
Hazard Ratio: 1.56 (95% CI 1.07–2.27)
In patients with acute exacerbation of COPD, elevated levels of VWF-N (a biomarker of von Willebrand factor formation) are associated with an increased risk of future major cardiovascular events.
May aid MACE risk stratification in acute COPD exacerbation; leaves open whether VWF-N-targeted interventions improve outcomes.
Cardiovascular diseases are common in patients with chronic obstructive pulmonary disease (COPD). Clot formation and resolution secondary to systemic inflammation may be a part of the explanation. The aim was to determine whether biomarkers of clot formation (products of von Willebrand Factor formation and activation) and clot resolution (product of fibrin degeneration) during COPD exacerbation predicted major cardiovascular events (MACE). The cohort was based on clinical data and biobank plasma samples from a trial including patients admitted with an acute exacerbation of COPD (CORTICO-COP). Neo-epitope biomarkers of formation and the activation of von Willebrand factor (VWF-N and V-WFA, respectively) and cross-linked fibrin degradation (X-FIB) were assessed using ELISAs in EDTA plasma at the time of acute admission, and analyzed for time-to-first MACE within 36 months, using multivariable Cox proportional hazards models. In total, 299/318 participants had samples available for analysis. The risk of MACE for patients in the upper quartile of each biomarker versus the lower quartile was: X-FIB: HR 0.98 (95% CI 0.65-1.48), VWF-N: HR 1.56 (95% CI 1.07-2.27), and VWF-A: HR 0.78 (95% CI 0.52-1.16). Thus, in COPD patients with an acute exacerbation, VWF-N was associated with future MACE and warrants further studies in a larger population.
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Kamstrup et al. (2022) conducted a cohort in Acute exacerbation of COPD (n=299). Upper quartile of VWF-N (biomarker of von Willebrand factor formation) vs. Lower quartile of VWF-N was evaluated on Time-to-first major cardiovascular events (MACE) (HR 1.56, 95% CI 1.07-2.27). In patients with an acute exacerbation of COPD, being in the upper quartile of VWF-N was associated with a higher risk of future MACE compared to the lower quartile (HR 1.56; 95% CI 1.07-2.27).
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