Von Willebrand factor for outcome prediction within different clinical stages of advanced chronic liver disease

• DOI: 10.1111/apt.17945
• Publication Date: 2024-03-14T09:27:00Z
• Authors: Nina Dominik; Bernhard Scheiner; Alberto Zanetto; Lorenz Balcar; Georg Semmler; Elena Campello; Michael Schwarz; Rafael Paternostro; Benedikt Simbrunner; Benedikt S. Hofer; Albert Friedrich ...; Matthias Pinter; Michael Trauner; Peter Quehenberger; Paolo Simioni; Thomas Reiberger; Mattias Mandorfer
• Keywords: Liver disease; Decompensation; Chronic liver disease

Summary Background and Aims The prognostic performance of von Willebrand factor (VWF) may vary across clinical stages advanced chronic liver disease (ACLD). Therefore, we investigated the evolution VWF other biomarkers throughout full ACLD spectrum evaluated their stage‐specific utility. Methods We retrospectively included Viennese patients with available information on hepatic venous pressure gradient (HVPG), C‐reactive protein (CRP)/VWF levels outcomes. were defined according to D'Amico et al. an external validation cohort from Padua. Results observed gradual increases in stages. In contrast, HVPG levelled off decompensated (dACLD), whereas MELD showed only minor changes early CRP did not increase until stage 3. was associated decompensation/liver‐related death compensated (cACLD) a fully adjusted model, while it independently predictive ACLF/liver‐related dACLD. After backward selection, HVPG/CRP/VWF remained main predictors cACLD. Notably, non‐invasive CRP/VWF‐based model comparable invasive HVPG‐based models ( C ‐index:0.765 ± 0.034 vs. 0.756 0.040). discriminative ability confirmed using another assay which yielded systematically lower values. Conclusion is biomarker that gradually all It particular value cACLD, where equivalent model. Systematic differences underline importance interlaboratory surveys. Moreover, our findings reinforce notion that, already inflammation key disease‐driving mechanism.