Plasma concentration of von Willebrand factor in acute myocardial infarction

Recent investigations have revealed the crucial role of von Willebrand fact or (vWF) in platelet thrombus formation under flow conditions. The plasma c oncentrations of vWF were measured together with various hemodynamic and he mostatic parameters in 51 cases of acute myocardial infarction. In 10 rando mly selected cases, the plasma concentrations and distribution of multimers VWF were serially determined after reperfusion therapy by percutaneous tra nsluminal coronary angioplasty (PTCA). The vWF concentration at the onset o f the acute myocardial infarction was significantly higher than in an age-m atched control group (vWF AG: 18.7 +/- 1.2 mu g/ml vs. 10.3 +/- 0.5 mu g/ml , p = 8.43x10(-) (12), mean +/- SE). Simultaneous determination of hemodyna mic and hemostatic parameters revealed that the only two parameters that we re significantly correlated with the patients' plasma VWF concentrations we re their pulmonary capillary wedge pressure (PCWP) and heart rate, suggesti ng a relationship between hemodynamic changes induced by the onset of myoca rdial infarction and the VWF plasma concentrations. Serial determinations r evealed that the vWF concentrations had not changed 1 h after reperfusion t herapy, but that they significantly increased by 24 to 72 h. The distributi on of the larger multimers of vWF also increased in the acute and subacute phase. The VWF concentration and multimer distribution normalized 14 days a fter the onset of the myocardial infarction. Our findings suggest that the VWF concentration increased in acute myocardial infarction patients, possib ly in association with the hemodynamic deterioration that occurs in acute m yocardial infarction.