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Prognostic value of von Willebrand factor for patients with atrial fibrillation: a meta-analysis of prospective cohort studies
  1. Yuan-Zheng Ye1,
  2. Ya-Fei Chang2,
  3. Bao-Zhu Wang1,
  4. Yi-Tong Ma1,
  5. Xiang Ma1
  1. 1 Xinjiang Medical University Affiliated First Hospital, Urumqi, China
  2. 2 The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
  1. Correspondence to Dr Xiang Ma, Xinjiang Medical University Affiliated First Hospital, Urumqi, China; maxiangxj{at}


Background It is unknown whether an abnormal level of von Willebrand factor (vWF) is correlated with the prognosis of patients with atrial fibrillation (AF) and current findings are controversial. This meta-analysis aimed to evaluate the association between vWF levels and the clinical prognosis of patients with AF.

Methods We searched prospective cohort studies on PubMed, Embase, Web of Science, Cochrane Library and WanFang databases for vWF and adverse events of AF from inception of the databases to July 2019. The risk ratios of all-cause death, cardiovascular death, major adverse cardiac events (MACE), stroke and bleeding prognosis in patients with AF were analysed using a fixed-effects model or random-effects model, and all included studies were evaluated with heterogeneity and publication bias analysis.

Results Twelve studies which included 7449 patients with AF were used in the meta-analysis. The average age was 71.3 years and the average follow-up time was 3.38 years. The analysis found that high vWF levels were associated with increased risks of all-cause death (RR 1.56; 95% CI 1.16 to 2.11, p=0.00400), cardiovascular death (RR 1.91; 95% CI 1.20 to 3.03, p=0.00600), MACE (RR 1.83; 95% CI 1.28 to 2.62, p=0.00090), stroke (RR 1.69; 95% CI 1.08 to 2.64, p=0.02000) and bleeding (RR 2.01; 95% CI 1.65 to 2.45, p<0.00001) in patients with AF.

Conclusions vWF is a risk factor for poor prognosis of AF, and patients with higher vWF levels have a higher risk of all-cause death, cardiovascular death, MACE, stroke and bleeding.

  • von Willebrand factor
  • atrial fibrillation
  • prognosis
  • meta-analysis

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  • Y-ZY and Y-FC are joint first authors.

  • Y-ZY and Y-FC contributed equally.

  • Y-TM and XM contributed equally.

  • Contributors Y-TM and XM designed the study. Y-FC, Y-ZY and B-ZW searched the literature independently. Y-FC, Y-ZY and B-ZW assessed the quality of the literature included in the study independently. Y-FC, Y-ZY and B-ZW extracted data independently. Y-FC and Y-ZY wrote and revised the manuscript.

  • Funding This work was funded by the National Natural Science Foundation of China (No 81660085).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement There are no data in this work. Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.

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