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von Willebrand Factor plasma levels variability in nonvalvular Atrial Fibrillation

Atrial Fibrillation (AF) is the most common cardiac arrhythmia of clinical significance; it increases the risk of mortality due to stroke. The mechanisms behind cerebral thromboembolism in AF are associated with a prothrombotic state, demonstrated by higher levels of von Willebrand Factor (vWF), a multimeric glycoprotein that plays a crucial role in platelet adhesion and aggregation and it has been proposed as a biomarker of endothelial dysfunction. Plasma vWF levels are elevated in patients with nonvalvular Atrial Fibrillation (NVAF) associated to the presence of cardiovascular risk factors. The variability in vWF plasma levels in healthy subjects is known and has a wide distribution, but there is no description available of the variability in AF patients and among types of AF. The aim of this study was determinate the variability in vWF plasma concentrations in patients with NVAF associated to cardiovascular risk factors. Search strategy included PubMed and Ovid. Keywords used were “Atrial Fibrillation” and “von Willebrand Factor”. Include original articles, with analysis of plasma vWF levels by ELISA, without acute stroke. Review articles and meta-analysis were excluded. Reviewed studies include 22 trials and 6542 patients with nonvalvular AF, associated to cardiovascular disease risk factors: age, sex, hypertension, heart failure, diabetes mellitus, prior stroke, coronary artery disease. Variability in vWF plasma levels were wide, with minimum values ​​of 77 IU/dl and maximum values of 245 IU/dl and a mean average of 146 IU/dl; Age of patients ranged between 54 and 78 years, and the percentage of males ranged between 23% and 80%. In Paroxysmal AF: 92 - 264 IU/dl; Persistent AF: 76 - 234 IU/dl; Permanent AF: 91 - 247 IU/dl. The variability in vWF plasma levels is affected by risk factors and the AF type, however vWF levels in AF patients are higher when compared with healthy subjects.

Credits: Gerardo Muñoz Cortés; Martha Eva Viveros Sandoval; Carlos Arturo Areán Martínez; Helios Eduardo Vega Gómez; Sandra Edith López Castañeda; Anel Gómez García

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