Usefulness of Plasma Von Willebrand Factor and Brachial Artery Endothelial Dysfunction to Predict Variant Angina

Abstract

Endothelial dysfunction and vascular inflammation may be associated with variant angina (VA). The aim of the present study was to investigate whether the level of von Willebrand factor (VWF) and flow-mediated dilation (FMD) are related to VA. This study included 74 patients (VA group: 52.1±11.9 years, 40 males) with normal coronary angiogram (CAG) and positive ergonovine provocation test (ERT), and 33 patients (control group:49.7±10.8 years, 23 males) and normal CAG with negative ERT. The level of VWF was significantly higher in VA than in control group (163.0±43.4% vs. 127.2±59.6%, p=0.008). FMD was significantly decreased in VA group compared with control group (9.0±4.0% vs. 11.2±3.1%, p=0.008). The levels of white blood cell counts was higher in VA than in control group (7509.4±2411.1/mm 3 vs. 6303.1±2027.1/mm, p=0.015). The level of total cholesterol was significantly higher in VA group compared with the control group (185.2±45.3 mg/dL vs.166.2±36.9 mg/dL, p=0.042). In multiple regression analysis, the VWF [odds ratio (OR), 11.14, 95% confidence interval (CI), 3.25-38.15: p 140% and FMD <10% provided the best separation of patients with and without VA (sensitivity 0.73, 0.66; specificity 0.78, 0.69, respectively). The increased level of VWF and decreased FMD are independently associated with VA. Non-invasive evaluation of VWF and FMD may serve as useful markers for detecting endothelial dysfunction and screening the VA patients.