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Updated: Jul 14, 2025

Investigating von Willebrand Factor Pathophysiology Using a Flow Chamber Model of von Willebrand Factor-platelet String Formation
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Acute myocardial infarction in von Willebrand disease: characteristics and outcomes

Orly Leiva1, Jean M Connors2, Nathan T Connell2

  • 1Leon H. Charney Division of Cardiology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.

Research and Practice in Thrombosis and Haemostasis
|October 9, 2023
PubMed

Insights

Patients with Von Willebrand disease (VWD) face a higher risk of bleeding readmissions after acute myocardial infarction (AMI). However, their risk for arterial thrombosis or all-cause readmissions did not significantly differ from those without VWD.

Area of Science:

  • Cardiology
  • Hematology
  • Public Health

Background:

  • Von Willebrand disease (VWD) is the most common inherited bleeding disorder.
  • Improved VWD prognosis leads to increased prevalence of age-related diseases like acute myocardial infarction (AMI).
  • Antithrombotic therapies for AMI increase bleeding risk, necessitating careful risk-benefit assessment in VWD patients.

Purpose of the Study:

  • To characterize the outcomes of patients with VWD following an AMI.
  • To evaluate 90-day readmission rates for any-cause, bleeding-related, and arterial thrombosis-related events in VWD patients post-AMI.

Main Methods:

  • Retrospective cohort study using the National Readmissions Database (2017-2018).
  • Case-control matching for age, sex, STEMI, PCI, diabetes, and CKD.
  • Time-to-event analysis using Cox proportional hazards regression.

Main Results:

  • 136 VWD patients were matched with 3400 controls.
  • No significant differences in 90-day all-cause (10.7% vs 11.5%) or arterial thrombosis (1.9% vs 3.1%) readmissions.
  • VWD was associated with a higher risk of 90-day bleeding readmissions (HR, 4.75; 95% CI, 1.05-21.66).

Conclusions:

  • VWD is linked to an increased risk of 90-day bleeding readmissions after AMI.
  • No increased risk of all-cause or arterial thrombosis readmissions was observed.
  • Further research is required to balance bleeding and thrombotic risks in VWD patients post-AMI.
Abstract

Keywords:
acute myocardial infarctionbleedingreadmissionvon Willebrand disease

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