The Correlation Between Plasma Von Willebrand Factor、ADAMTS13Levels And The Extent Of Coronary Artery Lesion In Acute Coronary Syndrome

Objective: To study the diversity of levels of Von willebrand factor (vWF) and vonwillebrand factor cracking protease (ADAMTS13) in patients of acute coronarysyndrome(ACS),meanwhile,to investigate the correlation between plasma von Willebrandfactor,von willebrand factor cracking protease (ADAMTS13) levels and the extent ofcoronary lesion in acute coronary syndrome,and to assess the clinical value．Method: A total of119patients of acute coronary syndrome(ACS) admitted weredivided into three clinical types including17patients with UA,31patients with NSTEMIand71patients with STEMI.20stable angina patients and20normal volunteers weredesignated as control groups.The severity of coronary artery lesions was evaluated by thenumber of diseased arteries and Gensini score for a decision of coronaryangiography(CAG) after admission.The venous blood samples were takenfrom the patient immediately after admission for detection of Von willebrand factor (vWF)and von willebrand factor cracking protease (ADAMTS13).To observe the dynamic changeof vWF and ADAMTS13before and after PCI.Results：1.Significant differences in vWF、ADAMTS13、hs-CRP、WBC and stressblood glucosewere found between ACS group and SA group、normal group（P<0.05);Nosignificant differences in vWF、ADAMTS13、hs-CRP、WBC and stress blood glucose werefound between SA group and normal group（P>0.05).2.No significant differences in vWF、ADAMTS13were found among three ACSclinical types（P>0.05).3.Significant differences between vWF、ADAMTS13levels and coronary vascular lesion count（P<0.001).4.Significant differences between vWF、 ADAMTS13levels and Gensini score（P<0.01）.5.There is a correlation between level of vWF,ADAMTS13and coronary vascularlesion count and Gensini score.There is a positive correlation between the ratio ofvWF/ADAMTS13and coronary vascular lesion count and Gensini score(r=0.7214，P<0.0001).There is a correlation between level of vWFAct and vWF-cp activity(r=-0.9165，P<0.0001）.6.The ROC curve show that the corresponding area under the ROC of vWFAg、vWFAct and ADAMTS13were0.902,0.924and0.889.7.Plasma levels of vWF in ACS patients when admitted were marked higher than thatafter PCI within24hours or48hours(P<0.01),lower than that after PCI moer than24hours or48hours(P<0.01);but no significant differences vWF-cp activity in ACS patientsbefore and after PCI（P>0.05).Conclusions:1.The level of vWF in patients of ACS were much higher than SAgroup and normal group,The levels of ADAMTS13were much lower than SA group andnormal group,there is a correlation between levels of vWF,ADAMTS13in ACS patientsand different degrees of coronary artery lesions.It can offer us the reference of clinical riskstratification and treatment of the hospitalized patients with ACS.2.Percutaneous coronary interention (PCI) may lead to myocardial reperfusion inpatients with ACS, and improve the prognosis, but also it can lead to vascular endothelialdamage, endothelial dysfunction, postoperative vWF levels may increases, then graduallydecreases.