Von Willebrand factor and oxidative stress parameters in acute coronary syndromes

Abstract

Considering the role of von Willebrand factor (vWf) in hemostasis, and the role of oxidative stress in the development of endothelial dysfunction and atherosclerotic disease, the aim of our study was to investigate the relationship between vWf, parameters of oxidative stress and different types of acute coronary syndromes (ACS). Levels of vWf activity (vWfAct), vWf antigen (vWfAg), nitric oxide (estimated through nitrites-NO(2)-), superoxide anion radical (O(2)-), hydrogen peroxide (H2O2), index of lipid peroxidation (estimated through thiobarbituric acid reactive substances-TBARS), superoxide dismutase (SOD) and catalase (CAT) activity of 115 patients were compared with those of 40 healthy controls. ACS patients had significantly higher vWfAct and vWfAg levels, as well as TBARS levels, while their levels of NO(2)-, H2O2, SOD and CAT activities were lower than controls'. vWfAg showed high specificity and sensitivity as a test to reveal healthy or diseased subjects. Multivariant logistic regression marked only vWfAg and TBARS as parameters that were under independent effect of ACS type. The results of our study support the implementation of vWf in clinical rutine and into therapeutic targets, and suggest that ACS patients are in need of antioxidant supplementation to improve their impaired antioxidant defence.

Figure 1

Values of von Willebrand factor activity (%) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically higher levels of vWfAct (175.27 ± 86.52 (166.0) % compared with 118.35 ± 33.11 (122.0) %; Mann-Whitney U test; **P < 0.01).

Figure 2

Values of von Willebrand factor antigen (%) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically higher levels of vWfAg (284.82 ± 126.66 (261.0) % compared with 104.57 ± 25.52 (108.0) %; t-test; **P < 0.01).

Figure 3

Values of nitric oxide (nitrites) levels (nmol/mL) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically lower levels of NO₂ ⁻ (12.88 ± 8.40 (10.52) nmol/mL compared with 15.98 ± 6.05 (17.20) nmol/mL; Mann-Whitney U test; *P < 0.05).

Figure 4

Values of superoxide anion radical levels (nmol/mL) in group of ACSs patient and in group of control subjects (mean + SD). ACSs patients and controls did not differ in levels of O₂ ⁻ (9.34 + 7.83 (7.58) nmol/mL compared with 10.63 + 22.90 (5.27); Mann Whitney U test; P > 0.05).

Figure 5

Values of hydrogen peroxide (nmol/mL) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically lower levels of H₂O₂ (2.75 ± 2.56 (2.12) nmol/mL compared with 8.11 ± 7.52 (5.21); Mann Whitney U test; **P < 0.01).

Figure 6

Values of index of lipid peroxidation (TBARS) levels (μmol/mL) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically higher TBARS compared with control subjects (3.12 ± 2.45 (2.48) U/g Hb × 10³ compared with 1.34 ± 0.47 (1.19) U/g Hb × 10³; t-test; **P < 0.01).

Figure 7

Values of superoxide dismutase activity (U/g Hb × 10³) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically lower SOD activity (156.83 ± 140.94 (89.54) U/g Hb × 10³ compared with 3078.21 ± 2664.35 (2433.71) U/g Hb × 10³; Mann-Whitney U test; **P < 0.01).

Figure 8

Values of catalase activity (U/g Hb × 10³) in group of ACSs patient and in group of control subjects (mean + SD). Compared with control subjects, ACSs patients had statistically lower CAT activity (5.55 ± 4.99 (4.00) U/g Hb × 10³ compared with 7.80 ± 5.10 (6.87) U/g Hb × 10³; Mann-Whitney U test; *P < 0.05).

Figure 9

Based on the data about sensitivity and specificity of the test (measuring vWfAct and vWfAg levels), receiver operating characteristic (ROC) curve as an indicator of the discriminating ability of the vWfAct and vWfAct test was obtained. ROC curve shows that the strength of vWfAg as an indicator of ACSs existence is very high.