Does deficiency of von Willebrand factor protect against cardiovascular disease? Analysis of a national discharge register
Does deficiency of von Willebrand factor protect against cardiovascular disease? Analysis of a national discharge register
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DOI：
10.1111/jth.13142
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发表时间：
2015-11-01
影响因子：
10.4
通讯作者：
Ragni, M. V.
中科院分区：
文献类型：
--
作者：
Seaman, C. D.;Yabes, J.;Ragni, M. V.
血管病因子（VWF）在血管损伤后和高剪切率部位的血小板粘附和聚集中起关键作用。VWF水平升高与缺血性心血管事件风险增加有关；然而，VWF缺乏是否对动脉粥样硬化具有保护作用尚不清楚。我们旨在比较血管性血友病（VWD）患者和非血管性血友病（VWD）患者心血管疾病（CVD）的患病率。方法：对2009 - 2011年全国住院患者样本（NIS）成人出院数据进行横断面分析。CVD被定义为缺血性心脏病、心肌梗死、缺血性脑血管疾病或周围血管疾病。为了进行患病率计算和统计分析，我们使用了NIS提供的排放水平权重来反映国家估计。CVD的组间比较采用Rao-Scott卡方检验。在调整年龄、性别和CVD相关危险因素后，采用多变量logistic回归来估计VWD患者发生CVD的可能性。结果：VWD患者的CVD患病率低于非VWD患者（15.0% vs 26.0%）。在调整年龄、性别和CVD相关危险因素后，VWD与CVD发生可能性降低相关（优势比0.85；95%可信区间0.79-0.92）。讨论：这些发现表明，VWD患者患CVD的风险降低，VWF缺乏可能对CVD有保护作用。
Introductionvon: Willebrand factor (VWF) plays a critical role in platelet adhesion and aggregation after vascular injury and at sites of high shear rate. Elevated VWF levels are associated with an increased risk of ischemic cardiovascular events; however, it is unclear whether VWF deficiency is protective against atherosclerosis. We aimed to compare the prevalence of cardiovascular disease (CVD) among patients with and without von Willebrand disease (VWD). Methods: A cross-sectional analysis was performed on discharge data for adults from the Nationwide Inpatient Sample (NIS) between the years 2009 and 2011. CVD was defined as ischemic heart disease, myocardial infarction, ischemic cerebrovascular disease, or peripheral vascular disease. For prevalence calculations and statistical analyses, we used discharge-level weights provided by the NIS to reflect national estimates. CVD was compared across groups by use of the Rao-Scott chi-square test. Multivariable logistic regression was used to estimate the likelihood of CVD in VWD patients after adjustment for age, gender, and CVD-related risk factors. Results: The prevalence of CVD in VWD patients was less than the prevalence of CVD in non-VWD patients (15.0% versus 26.0%). VWD was associated with a decreased likelihood of CVD after adjustment for age, gender, and CVD-related risk factors (odds ratio0.85; 95% confidence interval0.79-0.92). Discussion: These findings indicate that the risk of CVD is decreased among VWD patients, and that VWF deficiency may be protective against CVD.