Abstract Details

Title Profile of von Willebrand Factor and von Willebrand Factor Propeptide Levels in Patients with TIA or Ischemic Stroke Versus Controls

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 173

Objective

Background BACKGROUND: VWF:Ag II is reported to be a more sensitive marker of acute endothelial cell activation than VWF:Ag, because VWF:Ag II has a shorter half-life. These biomarkers have not been simultaneously studied following TIA or ischemic stroke.

Design/Methods DESIGN/METHODS: In this prospective, longitudinal observational, case-control study, plasma VWF:Ag and VWF:Ag II levels were assessed in 164 patients within 4 weeks of TIA or ischemic stroke(baseline), and then 14 days (14d) and >90 days (90d) after symptom onset, along with 27 healthy controls. TIA/stroke subtyping was performed using the TOAST classification. Multiple linear regression analysis was performed to examine the independent influence of certain variables on the comparisons between groups.

Results RESULTS: VWF:Ag and VWF:Ag II levels were higher in patients at baseline, 14d and 90d than in controls (p?0.03). VWF:Ag levels remained higher in patients than controls at baseline (p?0.03), but not at 14d or 90d after controlling for differences in age or hypertension between groups. VWF:Ag levels were higher in patients than controls at baseline and 90d after independently controlling for smoking status (p?0.04). 'Adjusted' VWF:Ag II levels were not significantly increased in patients vs. controls after controlling for age, hypertension or smoking status (p?0.1). Patients in the large vessel aetiology subgroup(N=46) had higher VWF:Ag and VWF:Ag II levels than controls at each timepoint (p?0.002). Cardioembolic TIA/stroke patients (N=25) had higher VWF:Ag and VWF:Ag II levels than controls at baseline only (p=0.03).

Conclusions CONCLUSIONS: von Willebrand factor secretion is enhanced following TIA/ischemic stroke, especially early after symptom onset and in patients with recently symptomatic large artery atherosclerosis. These findings reflect excessive endothelial and/or platelet activation in this patient population.

Authors/Disclosures
W. O. Tobin, PhD, MBBCh, BAO, FAAN (Mayo Clinic) PRESENTER	The institution of Dr. Tobin has received research support from Merck. The institution of Dr. Tobin has received research support from National Institutes of Health. Dr. Tobin has received publishing royalties from a publication relating to health care. Dr. Tobin has received personal compensation in the range of $0-$499 for serving as a Paid consulting and advisory activities with Mayo Clinic Platform_Accelerate.
Justin Kinsella, MD (St.Vincent's University Hospital)	Dr. Kinsella has nothing to disclose.
Mitchell S. Elkind, MD, MS, FAAN	Dr. Elkind has received personal compensation for serving as an employee of American Heart Association. Dr. Elkind has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Atria Academy.
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Raymond P. Murphy, FRCP	No disclosure on file
Dominick J. McCabe, MD, PhD	No disclosure on file

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