Predictive value of plasma von Willebrand factor antigen levels for long-term prognosis of elderly patients with acute myocardial infarction

doi:10.11958/20250518

Abstract

Abstract:

Objective To investigate the predictive value of plasma von Willebrand factor (VWF) antigen levels for the long-term prognosis of patients with acute myocardial infarction (AMI). Methods A total of 150 elderly patients diagnosed with AMI were selected and treated with percutaneous coronary intervention (PCI) at admission. The plasma VWF antigen level of the patients was detected within 24 hours after PCI. Patients were followed up for 12 months and were divided into the major adverse cardiac events (MACE) group and the non-MACE group according to the occurrence of MACE. The risk factors for MACE in AMI patients within 12 months were analyzed. The prognostic value of VWF antigen level in AMI patients were evaluated. The optimal cut-off value of plasma VWF antigen level was determined by receiver operating characteristic (ROC) curve. Patients were groups according to the optimal cut-off value. Kaplan-Meier curve was drawn to compare the occurrence of MACE in patients with different plasma VWF antigen levels. Results Among the 150 observed patients, 7 patients were lost to follow-up, and eventually 143 patients were included. In 143 patients there were 53 patients (37.1%) in the MACE group and 90 cases (63.9%) in the non-MACE group. The age, B-type natriuretic peptide (BNP), D-dimer and VWF antigen levels were significantly higher in the MACE group than those in the non-MACE group. The results of the Cox proportional hazards model showed that age increase (HR=1.085, 95%CI：1.014-1.160), increased plasma VWF antigen level (HR=1.030, 95%CI: 1.017-1.045) and increased BNP (HR=1.016, 95%CI: 1.004-1.027) were risk factors for elderly patients in the MACE group one year after surgery. The maximum approximately Youden index of plasma VWF antigen level for predicting MACE was 0.616, the optimal cut-off value was 162.5 μg/L, the sensitivity was 84.9% and the specificity was 76.7%. The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen ≥162.5 μg/L was shorter than that in the group with plasma VWF antigen < 162.5 μg/L (7.7 months vs. 11.6 months, Log-rank χ²=63.060, P<0.001). Conclusion The increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

Key words: myocardial infarction, risk factor, von Willebrand factor, major adverse cardiac events

CLC Number:

R541.4

Figures/Tables 4

References 22

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组别		n			性别（男/女）	年龄/ 岁			BMI/ （kg/m²）			吸烟史	饮酒史
非MACE组		90			58/32	71.8±5.5			23.2±3.7			42（46.7）	46（51.1）
MACE组		53			36/17	74.4±5.9			23.5±3.4			30（56.6）	29（54.7）
t或χ²					0.179	2.657^＊＊			0.482			1.318	0.174
组别				高血压史			糖尿病史			血管病变（单支/多支）
非MACE组				48（53.3）			53（58.9）			38/52
MACE组				28（52.8）			30（56.6）			24/29
χ²				0.003			0.072			0.127
组别	cTnT/（μg/L）				cTnI/（μg/L）				CK-MB/（μg/L）			BNP/（ng/L）
非MACE组	3.5±1.6				6.7±3.6				23.4±9.4			515.6±332.8
MACE组	3.2±1.1				6.2±3.3				22.8±8.0			815.9±537.2
t	1.207				0.827				0.389			4.130^＊＊
组别				D-D/ （mg/L）			FIB/ （g/L）			LDL-C/ （mmol/L）		HDL-C/ （mmol/L）
非MACE组				1.37±1.05			3.88±1.42			2.60±0.98		1.07±0.34
MACE组				2.33±1.82			4.05±1.38			2.64±1.03		0.99±0.28
t				4.004^＊＊			0.699			0.231		1.448
组别			TC/（mmol/L）					TG/（mmol/L）			VWF抗原/（μg/L）
非MACE组			4.20±1.39					1.50±1.07			154.3±23.3
MACE组			4.31±1.42					1.54±1.01			187.1±21.5
t			0.453					0.220			8.365^＊＊

组别		n			性别（男/女）	年龄/ 岁			BMI/ （kg/m²）			吸烟史	饮酒史
非MACE组		90			58/32	71.8±5.5			23.2±3.7			42（46.7）	46（51.1）
MACE组		53			36/17	74.4±5.9			23.5±3.4			30（56.6）	29（54.7）
t或χ²					0.179	2.657^＊＊			0.482			1.318	0.174
组别				高血压史			糖尿病史			血管病变（单支/多支）
非MACE组				48（53.3）			53（58.9）			38/52
MACE组				28（52.8）			30（56.6）			24/29
χ²				0.003			0.072			0.127
组别	cTnT/（μg/L）				cTnI/（μg/L）				CK-MB/（μg/L）			BNP/（ng/L）
非MACE组	3.5±1.6				6.7±3.6				23.4±9.4			515.6±332.8
MACE组	3.2±1.1				6.2±3.3				22.8±8.0			815.9±537.2
t	1.207				0.827				0.389			4.130^＊＊
组别				D-D/ （mg/L）			FIB/ （g/L）			LDL-C/ （mmol/L）		HDL-C/ （mmol/L）
非MACE组				1.37±1.05			3.88±1.42			2.60±0.98		1.07±0.34
MACE组				2.33±1.82			4.05±1.38			2.64±1.03		0.99±0.28
t				4.004^＊＊			0.699			0.231		1.448
组别			TC/（mmol/L）					TG/（mmol/L）			VWF抗原/（μg/L）
非MACE组			4.20±1.39					1.50±1.07			154.3±23.3
MACE组			4.31±1.42					1.54±1.01			187.1±21.5
t			0.453					0.220			8.365^＊＊

变量	β	SE	Wald χ²	P	HR	HR 95%CI
年龄	0.081	0.034	5.565	0.018	1.085	1.014~1.160
VWF抗原	0.030	0.007	18.630	<0.001	1.030	1.017~1.045
D-D	0.008	0.006	1.629	0.202	1.008	0.996~1.019
BNP	0.016	0.006	7.307	0.007	1.016	1.004~1.027

变量	β	SE	Wald χ²	P	HR	HR 95%CI
年龄	0.081	0.034	5.565	0.018	1.085	1.014~1.160
VWF抗原	0.030	0.007	18.630	<0.001	1.030	1.017~1.045
D-D	0.008	0.006	1.629	0.202	1.008	0.996~1.019
BNP	0.016	0.006	7.307	0.007	1.016	1.004~1.027