von Willebrand Factor Antigen and Activity in Patients with Acute Ischaemic Stroke at the University of Uyo Teaching Hospital, South South Nigeria

This study measures von Willebrand factor (vWF) antigen and activity in patients with acute ischaemic stroke at the University of Uyo Teaching Hospital, Akwa Ibom State, South South Nigeria, investigating the role of endothelial haemostatic dysfunction in stroke pathophysiology and its prognostic implications in this population. An analytical case-control study enrolled 80 patients with CT scan-confirmed acute ischaemic stroke admitted within 24 hours of symptom onset, 40 patients with haemorrhagic stroke as a disease comparison group, and 80 healthy controls matched by age and hypertension status. vWF antigen was measured by ELISA and vWF activity by ristocetin cofactor assay. Fibrinogen, D-dimer, Factor VIII activity, and platelet count were concurrently assessed. Neurological severity was scored using the National Institutes of Health Stroke Scale (NIHSS). vWF antigen and activity were significantly elevated in ischaemic stroke patients compared to haemorrhagic stroke and controls. vWF antigen correlated positively with NIHSS score at admission (r = 0.54) and with 30-day functional disability assessed by modified Rankin Scale. D-dimer and Factor VIII were co-elevated with vWF, consistent with an endothelial activation profile. Hypertension was the strongest clinical predictor of vWF elevation. vWF above 200 percent activity was associated with 2.8-fold increased odds of severe neurological deficit. The study establishes vWF as a clinically relevant haemostatic marker in Nigerian ischaemic stroke and recommends its incorporation into stroke haemostatic profiling. Keywords: von Willebrand factor, ischaemic stroke, endothelial activation, haemostasis, Akwa Ibom.