Comparison of von willebrand factor (VWF) and plasminogen activator inhibitor-1 (PAI-1) levels and prevelance of metabolic syndrome in patients with without coronary artery ectasia patients

Comparison of von willebrand factor (vWF) and plasminogen activator inhibitor-l (PAI-1) levels and prevelance of metabolic syndrome in patients with and without coronary artery ectasia patients. Abant Izzet Baysal University, Izzet Baysal Faculty of Medicine,Department of Cardiology,Thesis of Graduation,Bolu 2009.Coronary artery ectasia (CAE) is defined as localized or diffuse dilatation of the coronary arteries without spesific symptoms determined during routine coronary angiography. Its frequency has been found to be 0.3-10 % in different studies. The major feature of the CAE pathogenesis is the destruction of musculoelastic elements, accumulation of collagen and elastin in the media layer, and eventually thinning of the vessel wall. Metabolic syndrome (MS) is a clinical entity which includes central obesity, hypertension, dyslipidemia, glucose intolerance, vascular inflammation and prothrombotic environmentIn this study we aimed to assess the plasma levels of vWF and pai-1 which determine the endothelial function and fibrinolytic activity in patietns with and without CAE.One hundred and fifty seven consecutive patients with CAE, 52 patients with normal coronary arteries, and 50 patients with coronary artery disease (KAH) were included in the study and statistical analysis. Presence of MS and cardiovascular risk factors, such as age, gender presence of DM, hypertension, and smoking status, and patients medication were recorded. Plasma levels of vWF and PAI-1 were measured in all patients. This study included the patients who were diagnosed as CAE during routine coronary angiography and being regularly followed in our clinic between July 2003-June 2009.Among the cardiovascular risk factors, only the gender significantly differed between patients with and without CAE. The highest levels of vWF was found in patients with isolated CAE. PAI-1 levels were found to be lower in patients with CAE compared to patients with KAH and normal coronary arteries. The prevelance of MS was comparable in all our study population.Our study demonstrated that increased vWF levels shows the activated coagulation system and endothelial dysfunction and decreased PAI-1 levels, probably, activates fibrinolytic system and matrix metalloproteinase (MMP) in patients with CAE. Active plazmin plays a pivotal role in the development of ectasia activated by MMP in the fibriolytic system, resulting medial injury. vWF is a good indicator for endothelial dysfunction, and of its high levels show endothelial dysfunction in CAE patients.Key words: Coronary artery ectasia, vWF, PAI-1