Abstract Number: PB0728
Meeting: ISTH 2021 Congress
Background: Recently von willebrand factor has been identified as a marker of portal hypertension. The elevation of antigenic levels of this marker in liver cirrhosis , have led scientists to suggest that von willebrand factor could be a good prognostic marker, and thus bring improvements to the current prognostic scores which suffer from limitations since they do not take into account portal hypertension.
Aims: We aimed to assess the prognostic value of von-Willebrand factor , in the prediction of complications and mortality in patients with liver cirrhosis.
Methods: Patients with different stages of liver cirrhosis were recruited. vWF‐Ag levels were measured by immuno-turbidimetric assay. Clinical and biological data were determined at study entry. During follow‐up, complications of liver cirrhosis, death or transplantation were recorded.
Results: One hundred and fourty-five patients with liver cirrhosis (CPS-A 39%, B 42%; C 19%; 51% male; mean age 58 years; 64.8% with decompensated liver cirrhosis) were included.
During a median follow-up of 14 months (CI: 12–18), recurrence of decompensation was observed in in 65 (44.8%) patients and 35 (24.1%) patients deceased.
Raised levels of vWF‐Ag were associated with recurrence of decompensation ( P = 0.0001) and death ( P = 0.001).
The cut‐off value of ≥ 253% for vWF‐Ag, predicts relapse, with Sensitivity of 82.3% and specificity of 68%. While the cut‐off value of ≥ 324% for vWF‐Ag, predicts mortality, with Sensitivity of 91.4% and specificity of 75.2%.
This cut-off value defined two different populations of patients with a highly different survival probability: 38% after 12 months if VWF‐Ag was ≥ 324%, compared to 97% for those who had a VWF-Ag < 324%, (P = 0.0001), with a HR = 20.8 [CI 95%: 6.3 – 68.1].
|Prognostic value of VWF-Ag in the prediction of decompensation recurrence and mortality in patients with liver cirrhosis|
|Recurrence of decompensation||Death|
|N||80 (55.2%)||65 (44.8%)||110 (75.9%)||35 (24.1%)|
|vWF-Ag mean (%)||243||405||273||455|
|vWF-Ag IQR (%)||[173 – 300]||[308 – 462]||[190 – 325]||[361 – 516]|
|Cut-off values||Cut-off value : 253% AUC = 0.855
Se: 92.4% / Sp 68.9%
PPV 70.7% / NPV 91.8%
|Cut-off value : 324% AUC= 0.873
Se 91.4% / Sp 75.2%
PPV 54% / NPV 96.5%
Conclusions: vWF‐Ag may become a valuable marker for the prediction of mortality in patients with liver cirrhosis.
To cite this abstract in AMA style:El Horri M, Khachaa I, Cheikh Khelifa A, Berrah A, Baghdadi M, Moueden A, Benlaldj D, Seghier F. Antigenic Levels of von Willebrand Factor Predict Complications and Mortality in Patients with Liver Cirrhosis [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/antigenic-levels-of-von-willebrand-factor-predict-complications-and-mortality-in-patients-with-liver-cirrhosis/. Accessed December 8, 2021.
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