Plasma levels of von Willebrand factor and future risk of incident venous thromboembolism
Plasma levels of von Willebrand factor and future risk of incident venous thromboembolism
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DOI：
10.1182/bloodadvances.2020003135
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发表时间：
2021-01-12
期刊：
影响因子：
7.5
通讯作者：
Hansen, John-Bjarne
中科院分区：
文献类型：
--
作者：
Edvardsen, Magnus S.;Hindberg, Kristian;Hansen, John-Bjarne
几项病例对照研究报告了静脉血栓栓塞（VTE）患者血浆血管性血友病因子（VWF）水平与对照组相比升高。然而，由于很少有研究在前瞻性设计中研究这种关联，因此尚不清楚血浆VWF升高是否是VTE事件的风险因素或后果。因此，我们旨在研究血浆VWF水平与VTE风险之间的前瞻性相关性，并对深静脉血栓形成（DVT）和肺栓塞进行亚组分析。我们建立了一项基于人群的巢式病例对照研究，包括414例VTE病例和843例年龄和性别匹配的对照，该研究基于Tromso研究队列（1994-2007）。在队列基线（1994-1995年）采集血样。通过VWF水平的四分位数估计VTE的比值比（OR）和95%置信区间（CI）。我们发现，静脉血栓栓塞的风险在VWF水平的四分位数之间呈线性增加（趋势P = 0.023）。VWF最高四分位数的参与者与最低四分位数的参与者相比，VTE的OR为1.45（95%CI，1.03-2.03）。这种关联在无诱因VTE（OR，2.74; 95% CI，1.66-4.54）和无诱因DVT（OR，6.73; 95% CI，3.07-14.76）中最强。进一步调整体重指数、C反应蛋白、高血压、雌激素使用和吸烟对风险估计有适度的影响。总之，我们发现血浆VWF水平与将来发生静脉血栓栓塞的风险之间存在剂量依赖关系，尤其是无端事件。我们的研究结果表明，VWF可能是一个有前途的生物标志物，为未来的风险事件静脉血栓栓塞。
Several case-control studies have reported elevated plasma von Willebrand factor (VWF) levels in patients with venous thromboembolism (VTE) compared with controls. However, because few studies have investigated the association in a prospective design, it is unclear whether elevated plasma VWF is a risk factor or a consequence of the VTE event. Therefore, we aimed to investigate the prospective association between plasma VWF levels and risk of VTE, as well as to perform subgroup analyses of deep vein thrombosis (DVT) and pulmonary embolism. We established a population-based nested case-control study of 414 VTE cases and 843 age- and sex-matched controls based on the Tromso study cohort (1994-2007). Blood samples were collected at cohort baseline (1994-1995). Odds ratios (ORs) with 95% confidence intervals (CIs) for VTE were estimated across quartiles of VWF levels. We found that the risk of VTE increased linearly across quartiles of VWF levels (P for trend = .023). Participants with VWF in the highest quartile had an OR of 1.45 (95% CI, 1.03-2.03) for VTE compared with those in the lowest quartile. The association was strongest for unprovoked VTE (OR, 2.74; 95% CI, 1.66-4.54) and unprovoked DVT in particular (OR, 6.73; 95% CI, 3.07-14.76). Further adjustment for body mass index, C-reactive protein, hypertension, estrogen use, and smoking had a modest effect on the risk estimates. To conclude, we found a dose-dependent relationship between plasma VWF levels and future risk of incident VTE, and unprovoked events in particular. Our findings suggest that VWF may represent a promising biomarker for future risk of incident VTE.