稳定型冠心病患者血管假性血友病因子水平与心血管事件的关系

Relationship between von Willebrand factor level and cardiovascular events in patients with stable coronary heart disease

目的:探讨稳定型冠心病(CHD)患者动脉血浆血管假性血友病因子(vWF)水平分层与心血管事件的关系。方法:研究入选了2007年8月至2008年12月的88例稳定型CHD患者,收集其临床、冠脉造影(CAG)和经皮冠脉介入(PCI)资料。采用酶联免疫吸附测定技术测定所有入选者PCI前主动脉根部血浆vWF;除2例患者失访外,其余患者根据基线vWF水平分为:vWF高水平组(vWF≥13.5ng/ml,43例)和vWF低水平组(vWF<13.5ng/ml,43例),随访6年后的死亡率、非致死性心肌梗塞(MI)、心律失常、CAG+PCI、心衰、脑血管事件等主要不良心血管事件发生率。结果:平均随访74.7月,与vWF低水平组比较,vWF高水平组死亡率(9%∶9%),非致死性MI(12%∶7%)、心律失常(9%∶16%)、CAG+PCI人次(53%∶67%)、心衰人次(30%∶23%)、脑血管意外人次(14%∶26%)均无统计学差异(P均>0.05)。结论:稳定型冠心病血管假性血友病因子水平与长期的心血管事件无明显关系。

Objective： To explore the relationship between arterial plasma levels of von Willebrand factor （vWF） and cardiovascular events in patients with stable coronary heart disease （CHD）. Methods： A total of 88 stable CHD pa- tients from Aug 2007 to Dec 2008, were enrolled, their clinical, coronary angiography （CAG） and percutaneous coronary intervention （PCI） data were collected. Enzyme linked immunosorbent assay was used to measure arterial （aortic root） plasma vWF level before PCI. Except two lost cases, according to baseline vWF level, other patients were divided into high vWF level group （vWF≥13.5 ng/ml, n = 43） and low vWF level group （vWF 〈13.5 ng/ml, n = 43）. Incidence rate of major adverse cardiovascular events （MACE）, including mortality rate, non-fatal acute myocardial infarction （AMI）, CAG ＋ PCI etc. after six years were followed up. Results： After a mean 74. 7 months follow-up, there were no significant difference in mortality rate （9% Vs. 9%）, person-time of non-fatal AMI （12% vs. 7%）, arrhythmia （9% vs. 16%）, CAG＋ PCI （53% vs. 67%）, heart failure （30% vs. 23%）, cere-brovascular incident （14% vs. 26%） between low vWF level group and high vWF level group, P〉0.05 all. Conclu- sion： In patients with stable coronary heart disease, level of von Willebrand factor is not significantly related to long - term cardiovascular events.