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[Variations of plasma Willebrand factor and fibrinogen in coronary pathology]
M L Wiesel1, J M Mossard, L Grunebaum
1Service d'hémostase et de thrombose, INSERM U 311, centre régional de transfusion sanguine, Strasbourg, France.
Insights
Plasma von Willebrand factor is a reliable marker for detecting transmural myocardial infarction. Elevated levels indicate a prethrombotic state, aiding in early diagnosis of heart attacks.
Area of Science:
- Cardiology
- Hematology
- Biomarker Discovery
Context:
- Precordial chest pain is a common symptom requiring accurate diagnosis.
- Identifying reliable markers for prethrombotic states is crucial for patient management.
- Distinguishing between different causes of chest pain, including myocardial infarction and angina, is essential.
Purpose:
- To identify a reliable and easily measurable marker for prethrombotic states.
- To evaluate plasma levels of fibrinogen, von Willebrand factor, cholesterol, triglycerides, white blood cells, and platelets in patients with chest pain.
- To correlate these markers with specific diagnoses, particularly transmural myocardial infarction.
Summary:
- Studied 200 patients under 60 with chest pain, categorizing them into transmural myocardial infarction, non-Q wave infarction, unstable angina, and atypical chest pain groups.
- Measured fibrinogen, von Willebrand factor (vWF), cholesterol, triglycerides, white blood cells, and platelets.
- Found significant correlations between transmural myocardial infarction and elevated fibrinogen, vWF, and white blood cells. vWF levels peaked on day five post-infarction.
Impact:
- Plasma von Willebrand factor emerges as a potential reliable biomarker for diagnosing transmural myocardial infarction.
- This finding aids in the acute phase or within two weeks following a thrombotic cardiac event.
- Suggests vWF's utility in improving diagnostic accuracy and patient outcomes for acute coronary syndromes.
Abstract:
In order to determine a marker of prethrombotic states, reliable and easy to measure, we studied 200 patients under 60 years of age admitted to hospital for a precordial chest pain. Four groups were established: transmural myocardial infarction, acute infarction without Q wave, unstable angina and atypical chest pain. Fibrinogen, von Willebrand factor, cholesterol, and triglyceride levels were measured as well as the white cell and platelet counts. There was a statistically significant correlation between transmural myocardial infarction and increased levels of fibrinogen, von Willebrand factor and white blood cells. Von Willebrand factor was already increased in the acute phase of transmural infarction, reached a maximum on the fifth day and then decreased slowly during the following ten days. This study suggests that plasma von Willebrand factor could be a reliable marker of transmural myocardial infarction in the acute phase or during the two weeks following the thrombotic event.