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J Neurol Sci. 2017 Apr 15;375:404-410. doi: 10.1016/j.jns.2017.02.045. Epub 2017 Feb 24.

Profile of von Willebrand factor antigen and von Willebrand factor propeptide in an overall TIA and ischaemic stroke population and amongst subtypes.

Author information

1
Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN, United States.
2
Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Department of Neurology, St. Vincent's University Hospital, University College Dublin, Elm Park, Dublin 4, Ireland.
3
Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland.
4
Irish Centre for Vascular Biology, Royal College of Surgeons of Ireland, Ireland.
5
Department of Neurology, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Department of Vascular Surgery, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland.
6
Department of Age-Related Health Care, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Stroke Service, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland.
7
Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Stroke Service, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland.
8
Vascular Neurology Research Foundation, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Stroke Service, The Adelaide and Meath Hospital, Dublin, Incorporating the National Children's Hospital, Trinity College Dublin, Ireland; Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, London, UK; Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland. Electronic address: dominick.mccabe@amnch.ie.

Abstract

INTRODUCTION:

Von Willebrand factor propeptide (VWF:Ag II) is proposed to be a more sensitive marker of acute endothelial activation than von Willebrand factor antigen (VWF:Ag). Simultaneous data on VWF:Ag and VWF:Ag II profiles are very limited following TIA and ischaemic stroke.

METHODS:

In this prospective, observational, case-control study, plasma VWF:Ag and VWF:Ag II levels were quantified in 164 patients≤4weeks of TIA or ischaemic stroke (baseline), and then ≥14days (14d) and ≥90days (90d) later, and compared with those from 27 healthy controls. TIA and stroke subtyping was performed according to the TOAST classification. The relationship between VWF:Ag and VWF:Ag II levels and platelet activation status was assessed.

RESULTS:

'Unadjusted' 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, and were higher in patients at baseline and 90d after controlling for smoking status (p≤0.04). 'Adjusted' VWF:Ag II levels were not higher in patients than controls after controlling for age, hypertension or smoking (p≥0.1). Patients with symptomatic carotid stenosis (N=46) had higher VWF:Ag and VWF:Ag II levels than controls at all time-points (p≤0.002). There was no significant correlation between platelet activation status and VWF:Ag or VWF:Ag II levels.

CONCLUSIONS:

VWF:Ag and VWF:Ag II levels are increased in an overall TIA and ischaemic stroke population, especially in patients with recently symptomatic carotid stenosis. VWF:Ag II was not superior to VWF:Ag at detecting acute endothelial activation in this cohort and might reflect timing of blood sampling in our study.

KEYWORDS:

Case-control; Stroke; TIA; Von Willebrand factor; Von Willebrand factor propeptide

PMID:
28320178
DOI:
10.1016/j.jns.2017.02.045
[Indexed for MEDLINE]

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