Abstract Details

Title Increased von Willebrand Factor Propeptide Levels in Symptomatic Versus Asymptomatic Moderate and Severe Carotid Artery Stenosis - Results from the Platelets and Carotid Stenosis (PACS) Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S41 - (-)

Poster/Presentation
Number 007

Objective

Background von Willebrand factor propeptide (VWF:Ag II) is believed to be a more sensitive marker of acute endothelial cell activation than von Willebrand factor antigen (VWF:Ag), because VWF:Ag II has a shorter plasma half-life. VWF:Ag and VWF:Ag II levels have not been comprehensively assessed in asymptomatic and symptomatic carotid stenosis patients.

Design/Methods Plasma VWF:Ag II and VWF:Ag levels in patients with moderate or severe (?50%) asymptomatic carotid stenosis were compared with those from symptomatic carotid stenosis patients in the early (?4 weeks) and late phases (?3 months) after TIA or stroke in a multicentre, observational study. We longitudinally assessed symptomatic patients with matched data at both phases after symptom onset.

Results Data from 31 asymptomatic, 46 early phase symptomatic, and 35 late phase symptomatic patients (23 of whom had undergone carotid intervention) were analysed. VWF:AgII levels were higher in early (12.8mg/mL;p<0.001), late (10.6mg/mL;p=0.01) and late post-intervention (10.6mg/mL;p=0.038) symptomatic than asymptomatic patients (8.9mg/mL). There were no differences in VWF:Ag levels or VWF:Ag/VWF:AgII ratio between symptomatic and asymptomatic patients (p ? 0.056). VWF:AgII levels were also elevated in early (12.6mg/mL;p=0.004) and late severe symptomatic (10.9mg/mL;p=0.023) vs. severe asymptomatic carotid stenosis (8.8mg/mL). VWF:Ag levels decreased significantly in symptomatic patients followed up from the early to late phase after symptom onset (16.5 vs. 14.8mg/mL; p=0.048).

Conclusions Endothelial activation is enhanced in symptomatic compared with asymptomatic carotid stenosis, and decreases over time in patients with symptomatic carotid stenosis. VWF propeptide levels are a more sensitive marker of endothelial activation than VWF antigen levels in carotid stenosis patients. The value of endothelial biomarkers in predicting the early risk of stroke in patients with carotid stenosis deserves further study.

Authors/Disclosures
Justin Kinsella, MD (St.Vincent's University Hospital) PRESENTER	Dr. Kinsella has nothing to disclose.
W. O. Tobin, PhD, MBBCh, BAO, FAAN (Mayo Clinic)	The institution of Dr. Tobin has received research support from Mallinckrodt. Dr. Tobin has received publishing royalties from a publication relating to health care. Dr. Tobin has received personal compensation in the range of $500-$4,999 for serving as a Speaker with NeurologyLive.
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Colin Doherty, MD	The institution of Dr. Doherty has received research support from UCB pharma. The institution of Dr. Doherty has received research support from Science foundation Ireland.
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Raymond P. Murphy, FRCP	No disclosure on file
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Dominick J. McCabe, MD, PhD	No disclosure on file

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