The Cardioprotective Potential of von Willebrand Disease in Ischemic Heart Disease

von Willebrand factor (vWF) aids coagulation at sites of vessel injury. Elevated vWF levels have been associated with an increased risk of ischemic heart disease (IHD); however, it is unclear whether vWF deficiency, seen in patients with von Willebrand disease (vWD), protects people against IHD. We...

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Bibliographic Details
Published in:Texas Heart Institute journal 2022-07, Vol.49 (4)
Main Authors: Mihyawi, Nawfal, Ajmal, Muhammad, Fath, Ayman R, Bhattarai, Bikash, Yeneneh, Beeletsega
Format: Article
Language:English
Subjects:
Blood Coagulation
Clinical Investigation
Diabetes Mellitus
Humans
Myocardial Ischemia - complications
Myocardial Ischemia - diagnosis
Myocardial Ischemia - epidemiology
von Willebrand Diseases - complications
von Willebrand Diseases - diagnosis
von Willebrand Diseases - epidemiology
von Willebrand Factor - analysis
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Summary:von Willebrand factor (vWF) aids coagulation at sites of vessel injury. Elevated vWF levels have been associated with an increased risk of ischemic heart disease (IHD); however, it is unclear whether vWF deficiency, seen in patients with von Willebrand disease (vWD), protects people against IHD. We determined and compared the prevalence and risk of IHD in patients with versus without vWD by using data from the National Inpatient Sample (2009-2014), excluding patients younger than 18 and older than 75 years. The primary outcome was the odds ratio (OR) of IHD in patients with versus without vWD. Secondary outcomes were major medical comorbidities and demographic characteristics in patients with vWD. Of 224,475,443 weighted hospital-discharge samples, we identified 82,809 patients with a vWD diagnosis. The odds of IHD were lower in patients with vWD than in those without (OR=0.54; 95% CI, 0.52-0.56). After multivariable logistic regression analysis and adjustment for age, sex, and typical IHD risk factors (hypertension, smoking, diabetes, hyperlipidemia, chronic kidney disease, obesity, and family history of IHD), the likelihood of IHD remained lower in patients with vWD than in patients without (OR=0.65; 95% CI, 0.63-0.67). Our study shows that vWF deficiency, as seen in patients with vWD, is associated with a decreased prevalence of IHD. Further investigation may confirm these findings.
ISSN:0730-2347
1526-6702
1526-6702
DOI:10.14503/THIJ-20-7402