title: Baseline von Willebrand factor plasma levels and no-reflow phenomenon after primary percutaneous coronary intervention for ST segment elevation myocardial infarction.
abstract: No-reflow phenomenon is associated with a poor prognosis and its underlying mechanisms are still poorly understood. von Willebrand Factor (vWF) is a central molecule in haemostasis which plays an important role in acute coronary syndromes. However its possible role in no-reflow has not been assessed prior to this study. Quantitative baseline vWF plasma antigen was measured by immunoturbidometric assay in 54 consecutive patients with a first ST segment elevation acute myocardial infarction, treated by primary percutaneous coronary intervention within 12 h of symptom onset. Definitions of no-reflow were (1) angiographic: final TIMI flow ≤2 or final TIMI flow 3 with a myocardial blush grade <2; (2) electrocardiographic: lack of ST segment resolution (≤50% reduction of ST segment elevation at 90 min). Angiographic and electrocardiographic no-reflow was observed in 32 (59%) and 30 (56%) patients, respectively (only 9 patients had both type of no-reflow). Plasma levels of vWF were significantly higher in patients with angiographic no-reflow but not in those with electrocardiographic no-reflow. Also, vWF was the most powerful independent predictors of angiographic no-reflow (OR 3.8, 95% CI 1.1-12.9, p=0.033). Our results provide new insights into no-reflow pathophysiology with appealing therapeutic implications.
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: g.a.sgueglia@gmail.com.
authors.forename: Gregory Angelo
authors.initials: GA
authors.lastname: Sgueglia
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Spaziani
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cosentino
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Russo
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Felicita
authors.initials: F
authors.lastname: Andreotti
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Gaetano Antonio
authors.initials: GA
authors.lastname: Lanza
authors.affiliation: Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Landolfi
authors.affiliation: Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000209:etiology; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor