Acquired von Willebrand Syndrome (AVWS) as an Important Diagnostic Category of Disease

[See article vol. 22 : 265-271] In this issue of J Atherosclr Thromb, Kalbhenn J et al. presented an interesting report on "Acquired von Willebrand Syndrome (AVWS) " in patients treated with extracorporeal membrane oxygenation (ECMO) therapy. von Willebrad factor (VWF) is a unique plasma protein playing crucial role in thrombus formation by capturing flowing platelet to the damaged vascular wall. Thus, this protein plays essential roles both for the onset of thrombotic disease and bleeding events. However, not many of the physicians taking care of elderly patients (such as atherosclerotic patients) realize the importance of this protein because measurement of VWF is not included in the regular diagnostic blood tests. Due to its crucial role for hemostasis, congenital deficiency or abnormality of VWF was handled as congenital bleeding disorders mostly by pediatrician. In atherosclerotic patients, however, VWF is an important plasma marker for future thrombotic events. The Atherosclerosis Risk in Communities (ARIC) study demonstrated that the high level of plasma VWF was an independent risk factor for future onset of myocardial infarction.