For patients with coronary artery disease (CAD), the plasma concentration of von Willebrand factor (VWF) may be prognostic of major adverse cardiovascular events (MACEs), according to study results published in BMC Cardiovascular Disorders.

Prior research has demonstrated “that the plasma VWF derived from coronary vascular endothelial cells is significantly elevated when coronary artery injury occurs,” the investigators explained.

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The study was based on a literature review and meta-analysis of 15 research articles regarding VWF levels in 4184 patients with CAD. MACEs were reported by 960 of the patients; the remaining 3224 patients who did not report any MACEs formed the control group. Occurrences of MACEs in patients with CAD were analyzed with respect to plasma levels of VWF recorded at the time of admission and at 24 hours and 48 hours following admission.

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Overall, all patients were found to have elevated VWF plasma levels. Patients who experienced MACEs showed higher VWF plasma levels compared with patients without MACEs at 24 hours and 48 hours after admission but not at time of admission.

The pooled standardized mean difference (SMD) in plasma VWF levels between patient groups was 0.55 (95% CI, 0.30-0.80; P <.0001) at 24 hours following admission. At 48 hours, the pooled SMD was 0.70 (95% CI, 0.27-1.13; P =.001). At time of admission, VWF levels were similar between groups, with a pooled SMD of -0.25 (95% CI, -0.75 to 0.06; P =.12).

The study investigators concluded that the VWF plasma level at 24 or 48 hours after admission in a patient with CAD may be indicative of MACE risk. The investigators also cautioned that further research should be performed to verify these results.


1.     Fan M, Wang X, Peng X, et al. Prognostic value of plasma von Willebrand factor levels in major adverse cardiovascular events: a systematic review and meta-analysis [published online February 10, 2020]. BMC Cardiovasc Disord. doi: 10.1186/s12872-020-01375-7