Chonnam Med J.  2008 Aug;44(2):65-71. 10.4068/cmj.2008.44.2.65.

Usefulness of Plasma Von Willebrand Factor and Brachial Artery Endothelial Dysfunction to Predict Variant Angina

• Cho SH
• Park IH
• Jeong MH
• Choi JS
• Yun HJ
• Kim KH
• Hong YJ
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 2045752
• DOI: http://doi.org/10.4068/cmj.2008.44.2.65

Abstract

Endothelial dysfunction and vascular inflammation may be associated with variant angina (VA). The aim of the present study was to investigate whether the level of von Willebrand factor (VWF) and flow-mediated dilation (FMD) are related to VA. This study included 74 patients (VA group: 52.1+/-11.9 years, 40 males) with normal coronary angiogram (CAG) and positive ergonovine provocation test (ERT), and 33 patients (control group:49.7+/-10.8 years, 23 males) and normal CAG with negative ERT. The level of VWF was significantly higher in VA than in control group (163.0+/-43.4% vs. 127.2+/-59.6%, p=0.008). FMD was significantly decreased in VA group compared with control group (9.0+/-4.0% vs. 11.2+/-3.1%, p=0.008). The levels of white blood cell counts was higher in VA than in control group (7509.4+/-2411.1/mm3 vs. 6303.1+/-2027.1/mm3, p=0.015). The level of total cholesterol was significantly higher in VA group compared with the control group (185.2+/-45.3 mg/dL vs.166.2+/-36.9 mg/dL, p=0.042). In multiple regression analysis, the VWF [odds ratio (OR), 11.14, 95% confidence interval (CI), 3.25-38.15: p<0.001) and FMD (OR, 4.42, 95% CI, 1.32-14.82: p=0.016)] were predictors of VA. On the basis of the receiver-operating characteristics analysis, the cutoff value of VWF > 140% and FMD <10% provided the best separation of patients with and without VA (sensitivity 0.73, 0.66; specificity 0.78, 0.69, respectively). The increased level of VWF and decreased FMD are independently associated with VA. Non-invasive evaluation of VWF and FMD may serve as useful markers for detecting endothelial dysfunction and screening the VA patients.

Keyword

Angina; Inflammation; Endothelium

MeSH Terms

Brachial Artery
Cholesterol
Endothelium
Ergonovine
Humans
Inflammation
Leukocyte Count
Mass Screening
Plasma
Sensitivity and Specificity
von Willebrand Factor
Cholesterol
Ergonovine
von Willebrand Factor

Figure

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  Fig. 1 The flow-mediated dilation (FMD) was significantly decreased in patients with variant angina (Group I) than in control patients (Group II). However, the nitroglycerin-mediated dilation (NMD) was not different between both groups.

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  Fig. 2 The receiver-operating characteristics (ROC) curve to determine optimal cutoff value of Von Willebrand factor (Left) and flow-mediated dilation (Right) for predictors of patients with variant angina. CI, confidence interval.

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