Prognostic role of plasma von Willebrand factor and soluble E-selectin levels for future cardiovascular events in a 'real-world' community cohort of patients with atrial fibrillation

Background Endothelial damage/dysfunction may contribute to a prothrombotic state in patients with atrial fibrillation (AF) and the increased risk of thromboembolism and cardiovascular events. Raised plasma von Willebrand factor (vWf), an established marker of endothelial damage/dysfunction, has been associated with stroke and vascular events, at least in a clinical trial population. Soluble E‐selectin (sE‐sel) is another biomarker of endothelial activation/dysfunction, with more limited data on prognostic outcomes in AF. Objective To assess the relationship between the levels of vWf, sE‐sel and clinical adverse outcomes (including stroke, MI and all‐cause mortality) in a ‘real‐world’ community cohort of patients with AF. Methods We studied 423 patients (mean age 72·7 ± 8·4 years, 55·6% male) with nonvalvular AF, with a median follow‐up of 19 (9–31) months. Plasma vWf and sE‐sel levels were measured using enzyme‐linked immunosorbent assay (ELISA). Results There were 94 clinical adverse events (22·2%) observed during a median follow‐up of 19 months. Patients with clinical events had significantly higher vWf (P