In:
British Journal of Haematology, Wiley, Vol. 182, No. 1 ( 2018-07), p. 93-105
Kurzfassung:
Some comorbidities, such as hypertension, are associated with higher von Willebrand factor ( VWF ) levels in the general population. No studies have been conducted to assess this association in patients with von Willebrand disease ( VWD ). Therefore, we studied this association in patients with type 1 ( n = 333) and type 2 ( n = 203) VWD from the ‘WiN” study. VWF antigen ( VWF :Ag) was higher in type 1 VWD patients with hypertension [difference: 0·23 iu/ml, 95% confidence interval ( CI ): 0·11–0·35], diabetes mellitus (0·11 iu/ml, 95% CI : −0·02 to 0·23), cancer (0·14 iu/ml, 95% CI : 0·03–0·25) and thyroid dysfunction (0·14 iu/ml, 95% CI : 0·03–0·26) than in patients without these comorbidities (all corrected for age, sex and blood group). Similar results were observed for VWF collagen binding capacity ( VWF : CB ), VWF activity as measured by the VWF monoclonal antibody assay ( VWF :Ab) and factor VIII ( FVIII ) coagulant activity ( FVIII :C). In type 1 VWD , age was associated with higher VWF :Ag (0·03 iu/ml; 95% CI : 0·01–0·04), VWF : CB (0·02 iu/ml; 95% CI : 0·00–0·04), VWF :Ab (0·04 iu/ml; 95% CI : 0·02–0·06) and FVIII :C (0·03 iu/ml; 95% CI : 0·01–0·06) per decade increase. After adjustment for relevant comorbidities, these associations were no longer significant. Despite the higher VWF and FVIII levels, type 1 VWD patients with comorbidities had more bleeding episodes, particularly during surgery. There was no association between comorbidities and VWF / FVIII levels or bleeding phenotype in type 2 VWD patients. In conclusion, comorbidities are associated with higher VWF and FVIII levels in type 1 VWD and may explain the age‐related increase of VWF and FVIII levels.
Materialart:
Online-Ressource
ISSN:
0007-1048
,
1365-2141
DOI:
10.1111/bjh.2018.182.issue-1
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2018
ZDB Id:
1475751-5
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