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Von Willebrand factor: A predictor of cardiovascular events in survivors of myocardial infarction
ABSTRACTS OF 12TH INTNAT’L CONGRESS
S180
Vol. 65, SuppI. 1
P354 VON WILLEBRAND FACTOR: A PREDICTOR OF CARDIOVASCULAR EVENTS IN SURVIVORS OF MYOCARDJAL INFARCTION T.K. Nilsson, 0. Johnson and J.H. Jansson Departments of Clinical Chemistry and Medicine, University Hospital, Ume&, and Department of Medicine, Skelleftea Hospital, S This study evaluates the role of von Willebrand factor (vWF) and established cardiovascular risk factors as predictors of reinfarction and cardiovascular mortality. In 1982- 1983, I23 consecutive survivors of acute myocardial infarction (AMI) were entered into the study. They were sampled 3 months after discharge from hospital. In titrated plasma samples, vWF was measured by an ELISA. Lipid levels and clinical risk factors were also recorded. The mean observation time was 4.9 years, during which 23 patients died and 36 had at least one reinfarction. High concentrations of vWF were independently associated with both reinfarction and mortality in Cox regression analyses. The risk increased progressively through the quartiles of the vWF levels. A history of angina pectoris was also independently associated with both endpoints. Hypertension was independently associated with mortality but not with reinfarction. Serum cholesterol and triglycerides, and fibrinolytic activity, were not associated with these endpoints. We conclude that vWF, which is synthesized in vascular endothelium and can be regarded as a marker of endotheiial dysfunction, emerges as a novel risk indicator which may be a useful addition to the arsenal of means of identifying a high-risk group for reinfarction and death among patients with AMl.
ABORTED MYOCARDIAL INFARCTION: INCIDENCE AND CLINICAL CHARACTERISTICS MChiti, A.Bartoloui, A.Giomi, F.Fantoni, A.AlJeri, F.Del Citerna Coronary Care Unit, Hospital of Pistoia, Italy the incidence, clinical characteristics and prognosis of aborted myocardial infarction (AB-MI), we retrospectively analyzed the pts with acute MI (AMI) submitted to thrombolytic therapy (TT) at our CCU between 1989 and 1991. AB-MI was defined by the presence of chest pain lasting from at least 30’ and ST elevation unresponsive to intravenous nitroglycerin, without development of Q-waves and CK elevation after TT. Among 239 AM1 pts who underwent TT, 17 (7%) developed AR-MI (mean age S&9). In the following table In order
to evaluate
Characterizing features are the young pts’ age, a very low delay between the onset of symptoms and TT, a good left ventricular function both early after AM1 and during follow-up, and a high incidence of in-hospital post-infarction angina followed by clinical stabilization during the next year. Instead, in NQ-MI we have observed a greater tendency to clinical resumption during follow-up. The preserved left ventricular function and the low l-year mortality in both groups of pts. further underline the importance of early TT administration in AMI.
S180
Vol. 65, SuppI. 1
P354 VON WILLEBRAND FACTOR: A PREDICTOR OF CARDIOVASCULAR EVENTS IN SURVIVORS OF MYOCARDJAL INFARCTION T.K. Nilsson, 0. Johnson and J.H. Jansson Departments of Clinical Chemistry and Medicine, University Hospital, Ume&, and Department of Medicine, Skelleftea Hospital, S This study evaluates the role of von Willebrand factor (vWF) and established cardiovascular risk factors as predictors of reinfarction and cardiovascular mortality. In 1982- 1983, I23 consecutive survivors of acute myocardial infarction (AMI) were entered into the study. They were sampled 3 months after discharge from hospital. In titrated plasma samples, vWF was measured by an ELISA. Lipid levels and clinical risk factors were also recorded. The mean observation time was 4.9 years, during which 23 patients died and 36 had at least one reinfarction. High concentrations of vWF were independently associated with both reinfarction and mortality in Cox regression analyses. The risk increased progressively through the quartiles of the vWF levels. A history of angina pectoris was also independently associated with both endpoints. Hypertension was independently associated with mortality but not with reinfarction. Serum cholesterol and triglycerides, and fibrinolytic activity, were not associated with these endpoints. We conclude that vWF, which is synthesized in vascular endothelium and can be regarded as a marker of endotheiial dysfunction, emerges as a novel risk indicator which may be a useful addition to the arsenal of means of identifying a high-risk group for reinfarction and death among patients with AMl.
ABORTED MYOCARDIAL INFARCTION: INCIDENCE AND CLINICAL CHARACTERISTICS MChiti, A.Bartoloui, A.Giomi, F.Fantoni, A.AlJeri, F.Del Citerna Coronary Care Unit, Hospital of Pistoia, Italy the incidence, clinical characteristics and prognosis of aborted myocardial infarction (AB-MI), we retrospectively analyzed the pts with acute MI (AMI) submitted to thrombolytic therapy (TT) at our CCU between 1989 and 1991. AB-MI was defined by the presence of chest pain lasting from at least 30’ and ST elevation unresponsive to intravenous nitroglycerin, without development of Q-waves and CK elevation after TT. Among 239 AM1 pts who underwent TT, 17 (7%) developed AR-MI (mean age S&9). In the following table In order
to evaluate
Characterizing features are the young pts’ age, a very low delay between the onset of symptoms and TT, a good left ventricular function both early after AM1 and during follow-up, and a high incidence of in-hospital post-infarction angina followed by clinical stabilization during the next year. Instead, in NQ-MI we have observed a greater tendency to clinical resumption during follow-up. The preserved left ventricular function and the low l-year mortality in both groups of pts. further underline the importance of early TT administration in AMI.