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High Plasma von Willebrand Factor Level is Associated with Increased Risk of upper Gastrointestinal Bleeding in Patients with Chronic Coronary Syndromes Receiving Long-term Antiplatelet Therapy

V. Korobkova1, A. Komarov1, O. Shakhmatova1, A. Dobrovolsky1, E. Novikova1, E. Guskova1, E. Titaeva1, E. Yarovaya2, A. Shuleshova1, E. Panchenko1

1Federal State Budget Educational Institution National Medical Research Centre of Cardiology, Moscow, Russian Federation, 2Federal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Faculty of Mechanics and Mathematics, Moscow, Russian Federation

Abstract Number: PB0936

Meeting: ISTH 2021 Congress

Theme: Platelet Disorders, von Willebrand Disease and Thrombotic Microangiopathies » VWF and von Willebrand Factor Disorders - Clinical Conditions

Background: Plasma von Willebrand factor (VWF) levels have been proposed as a marker of atherosclerotic burden and as a risk factor for cardiovascular events. Numerous clinical and experimental reports suggest that high VWF levels reflect damage to the endothelium or endothelial dysfunction. It is unclear whether variations in VWF levels may determine the rate of bleeding complications in pts with atherosclerosis receiving antithrombotic therapy.

Aims: To assess the predictive value of VWF levels for upper gastrointestinal bleeding (UGIB) in patients with chronic coronary syndromes (CCS) receiving long-term antithrombotic therapy.

Methods: Single center prospective Registry of Long-term AnTithrombotic TherApy (REGATTA-1 NCT04347200) included 934 pts with CCS (78.6% males, age 61±10.7 yrs, 76% after elective PCI). The UGIB annual incidence was 1.9 events per 100 patient-years. VWF was determined in baseline blood samples from 28 pts with UGIB and 141 controls, matched for age, sex and main clinical risk factors.  

Results: The median for VWF was 139[interquartile range 107-168] %. Frequency of UGIB was higher in the Q2-Q5 (> 105%) compared to the lower quintile of VWF distribution (20.8% vs 2.6 %,  p=0.008). VWF showed acceptable discriminatory ability for UGIB, AUC = 0.67, 95% CI =0.59– 0.74, p = 0.0014 (figure 1). High VWF remained significant after adjustment for anatomical and clinical variables in regression model taking into account ESC panel’s UGIB risk factors (OR 14.02, 95% CI 1.41-139.42; p=0.023).
VWF as prognostic biomarker for upper gastrointestinal bleeding in patients with chronic coronary syndromes (ROC curve analysis).

Conclusions: VWF should be considered as a valuable prognostic biomarker to improve the prediction of UGIB in addition to well-known scoring systems in CCS patients receiving long-term antithrombotic therapy.

To cite this abstract in AMA style:

Korobkova V, Komarov A, Shakhmatova O, Dobrovolsky A, Novikova E, Guskova E, Titaeva E, Yarovaya E, Shuleshova A, Panchenko E. High Plasma von Willebrand Factor Level is Associated with Increased Risk of upper Gastrointestinal Bleeding in Patients with Chronic Coronary Syndromes Receiving Long-term Antiplatelet Therapy [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/high-plasma-von-willebrand-factor-level-is-associated-with-increased-risk-of-upper-gastrointestinal-bleeding-in-patients-with-chronic-coronary-syndromes-receiving-long-term-antiplatelet-therapy/. Accessed September 24, 2023.

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