vWF升高预测非ST段抬高的急性冠脉综合征患者的不良预后

Increase of von Willebrand Factor predicting adverse outcome in patients of acute coronary syndromes with non-ST-segment elevation

目的评价血管性血友病因子(von Willebrand factor,vWF)对判断非ST段抬高的急性冠脉综合征(NSTE-ACS)患者预后的意义。方法70例NSTE-ACS患者,检测基线时、入选12 h及48 h血浆vWF水平。研究的复合终点包括随机入选后30 d内的死亡、心肌梗死或复发心肌梗死以及复发心绞痛。比较发生终点事件与未发生终点事件的患者之间血浆vWF水平的区别。结果①在随访30 d时,22例(31.4%)发生了至少一个终点事件。在有终点事件的患者与无终点事件的患者间,48 h与基线vWF浓度的差值为100±34%比73±33%(P<0.05)。②在有终点事件的患者与无终点事件的患者间,男性比率为55%比75%(P<0.05),多支血管病变比率为73%比50%(P<0.05)。结论非ST段抬高的急性冠脉综合征发病早期48 h内vWF的浓度升高是30 d终点事件的独立预测因素。

Objective To study the predictive value of yon Willebrand factor （vWF） in judging non-ST-segment elevation acute coronary syndromes （NSTE-ACS）. Methods 70 patients with NSTE-ACS were enrolled from Beijing friendship hospital cardiac department. Blood sample were taken and the levels of vWF were measured on admission and after 12, 48 hours respectively. The efficacy end point was a composite of death, myocardial infarction and recurrent isehemia within 30 days after enrollment, vWF levels were compared between patients with death, myocardial infarction and recurrent isehemia and patients without death, myocardial infarction and recurrent ischemia. Results （1）At least one end point took place in 22 cases（31.4% ） within 30 days, Increase of vWF during 48 hours was 100 ± 34% in patients with adverse outcomes vs 73 ± 33% （P 〈 0. 05） in patients with favorable outcomes. （2）Male ratio was 55% in patients with adverse outcomes vs. 75% in patients with favorable outcomes （P 〈0. 05）, The ratio of multivessel disease was 73% in patients with adverse outcomes vs 50% in patients with favorable outcomes （P 〈 0. 05）. Conclusion Increase of vWF within 48 hours is an independent predictor for the composite end point within 30days.