ADAMTS13 activity, high VWF and FVIII levels in the pathogenesis of deep vein thrombosis

Pagliari, M.T.; Boscarino, M.; Cairo, A.; Mancini, I.; Martinelli, I.; Bucciarelli, P.; ... ; Peyvandi, F. (2021)

Article / Letter to editor

Background: Deep vein thrombosis (DVT) is a common multi-factorial disease with a partially understood aetiology. Although the roles of high factor (F)VIII and von Willebrand factor (VWF) levels are recognized, that of ADAMTS13 is still unclear.Aim: To assess the association between ADAMTS13 activity levels, VWF antigen (VWF:Ag) and FVIII coagulant activity (FVIII:C) levels and DVT.Materials and methods: 365 Italian DVT patients and 292 ageand sex-matched controls were considered. Plasma ADAMTS13 activity was measured using FRETS-VWF73 assay. VWF:Ag and FVIII:C were measured using immunoassay and one-stage clotting assay (ACL TOP analyzer), respectively. Quartile analyses were performed to evaluate the individual association between ADAMTS13 activity, VWF:Ag, FVIII:C and DVT. The combined effect of high VWF levels ( 4th quartile) and low ADAMTS13 levels (< 1st quartile) was evaluated using binary variables. All models were ageand sex-adjusted. Estimated risks were reported as Odds ratio (OR) with 95% confidence intervals (CI).Results: ADAMTS13 activity was lower in DVT patients (94% vs. 98% of controls). Patients with an ADAMTS13 activity <1st quartile (86%) showed a 1.6-fold increased risk of DVT (95%CI, 1.05-2.55). The combination of low ADAMTS13 activity and high VWF:Ag levels was associated with a 15-fold increased risk (95%CI, 7.80-33.80). VWF:Ag and FVIII:C were associated to DVT with a dose-response relationship.Conclusions: ADAMTS13 activity < 86% was associated with a moderate risk of DVT. The co-presence of low ADAMTS13 activity and high VWF levels resulted in a strong synergistic effect on DVT risk. The association of VWF:Ag and FVIII:C with DVT was confirmed.

• ADAMTS13 human protein
• Risk factor
• Deep vein thrombosis
• von Willebrand factor
• Factor VIII

• All authors: Pagliari, M.T.; Boscarino, M.; Cairo, A.; Mancini, I.; Martinelli, I.; Bucciarelli, P.; Rossi, F.; Rosendaal, F.R.; Peyvandi, F.
• Date: 2021-01-01
• Journal: Thrombosis Research: Vascular Obstruction, Hemorrhage and Hemostasis
• Volume: 197
• Pages: 132 - 137
• DOI: doi:10.1016/j.thromres.2020.10.037
• Link: https://www.sciencedirect.com/science/article/pii/S0049384820305934?via%...