Correlation of plasma von Willebrand factor levels, an index of endothelial damage/dysfunction, with two point-based stroke risk stratification scores in atrial fibrillation.

To test the hypothesis that the new CHADS2 and Framingham point-based risk stratification scores could be related to plasma vWf (a plasma index of endothelial damage/dysfunction) and soluble E-selectin (an index of endothelial activation) levels in a large cohort of AF patients, we studied 200 consecutive patients (101 male; 72+/-9 years) attending our anti-coagulation clinic for the initiation of anticoagulation treatment with acenocoumarol. AF patients had a median CHADS2 score of 2 (1-2) and a median Framingham point-based risk score of 14 (9-21). Results of research indices in our AF patients were as follows: vWf 142.8+/-41.8 IU/dL and sE-sel 44 (31-62) ng/mL. There were significant correlations between plasma vWf levels and both risk CHADS2 and Framingham risk scores (vWf-CHADS2 risk score: Spearman, r=0.249, p<0.001; vWf-Framingham risk score: r=0.294, p<0.001). sE-sel did not show any significant correlation with both risk scores (sE-sel-CHADS2 risk score: r=-0.054, p=0.460; sE-sel-Framingham risk score: r=0.062, p=0.460). There were no statistically significant correlations between vWf and sE-sel (r=-0.127, p=0.081). Both CHADS2 and Framingham risk scores were significantly correlated with each other, r=0.627, p<0.001. In conclusion, in a wide cohort of non-selected and consecutive AF patients, endothelial damage/dysfunction (assessed by plasma vWf levels) but not endothelial activation (sE-sel) correlated with two new risk stratification scores for stroke in AF. Further prospective studies are needed to assess the prognostic role of prothrombotic indices in AF in relation to stroke and thromboembolic events, and their role in complementing clinical risk stratification schemas.