Prognostic value of plasma von Willebrand factor-cleaving protease (ADAMTS13) antigen levels in patients with coronary artery disease

Mitsutoshi Miura; Koichi Kaikita; Masakazu Matsukawa; Kenji Soejima; Shunichiro Fuchigami; Yuji Miyazaki; Takamichi Ono; Takashi Uemura; Kenichi Tsujita; Seiji Hokimoto; Hitoshi Sumida; Kunihiko Matsui; Hiroshige Yamabe; Hisao Ogawa

doi:10.1160/TH09-08-0568

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2010; 103(03): 623-629
DOI: 10.1160/TH09-08-0568

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Prognostic value of plasma von Willebrand factor-cleaving protease (ADAMTS13) antigen levels in patients with coronary artery disease

Mitsutoshi Miura

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Koichi Kaikita

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Masakazu Matsukawa

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Kenji Soejima

²First Research Department, The Chemo-Sero-Therapeutic Research Institute, Kumamoto, Japan

,

Shunichiro Fuchigami

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Yuji Miyazaki

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Takamichi Ono

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Takashi Uemura

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Kenichi Tsujita

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Seiji Hokimoto

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Hitoshi Sumida

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Kunihiko Matsui

³Department of General Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Hiroshige Yamabe

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

,

Hisao Ogawa

¹Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan

› Institutsangaben

Abstract

Summary

High plasma level of von Willebrand factor (VWF) is a marker of future cardiovascular events in patients at high risk of coronary artery disease (CAD). The purpose of this study was to examine the changes and the prognostic value of plasma VWF-cleaving protease (ADAMTS13) levels in patients with CAD. Plasma VWF and ADAMTS13 levels were measured in 225 patients with CAD (152 men and 73 women, age, 70.3 ± 8.9 years, mean ± SD) and 100 patients without CAD who were ageand gender-matched to the CAD patients (60 men and 40 women, age, 68.6 ± 8.9 years). The CAD patients had higher VWF and lower ADAMTS13 antigen levels compared to patients without CAD. During 22.3 ± 10.4 months follow-up period, 20 major adverse cardiac and cerebrovascular events (MACCE) occurred in 222 patients with CAD who could be followed up. Kaplan-Meier analysis demonstrated that CAD patients with high plasma VWF antigen levels were significantly more likely to develop MACCE. Furthermore, eight cardiac and cerebrovascular thrombotic events [acute coronary syndrome (n=4) and cerebral infarction (n=4)] occurred in CAD patients with both high plasma VWF and low ADAMTS13 antigen levels. Multivariate Cox hazards regression analysis identified high plasma VWF and low ADAMTS13 antigen levels as significant and independent predictors of future MACCE and thrombotic events during the follow-up period in CAD patients. Our findings suggest that low plasma ADAMTS13 as well as high VWF level is a useful predictor of cardiac and cerebrovascular events in CAD patients.

Keywords

von Willebrand factor - ADAMTS13 - thrombosis

Volltext

Referenzen

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