Increased level of von Willebrand factor is significantly and independently associated with diabetes in postinfarction patients

Diabetes is an established risk factor for reinfarction and cardiac death i n postinfarction patients. Since the underlying mechanism of diabetes-relat ed risk is not fully understood we aimed to evaluate the association betwee n lipids, thrombogenic factors and diabetes in postinfarction patients. The study population consisted of 1,045 postinfarction patients (846 non-diabe tic, 125 non-insulin- and 74 insulin-requiring diabetics) with the followin g blood tests performed 2 months after an index myocardial infarction: lipo protein (a), apolipoprotein-B, apolipoprotein-A, cholesterol, HDL cholester ol, triglycerides, insulin, von Willebrand factor (vWF), fibrinogen, factor VII, D-dimer, and plasminogen activator inhibitor (PAI-1). After adjustmen t for relevant clinical covariates, non - insulin-requiring diabetes was si gnificantly (p < 0.05) associated with elevated levels of (odd ratios per I log unit increase in parenthesis) vWF (1,74) and PAI-1 (1.42) whereas insu lin requiring diabetes was associated with even more elevated levels of vWF (4.68), but not with increased levels of PAI-1. No significant differences in lipid levels were observed among three groups. In conclusion, increased level of von Willebrand factor is significantly and independently associat ed with diabetes in postinfarction patients, suggesting that endothelial da mage is the primary mechanisms contributing to an increased occurrence of v ascular and cardiac events in diabetic postinfarction patients.