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Investigating von Willebrand Factor Pathophysiology Using a Flow Chamber Model of von Willebrand Factor-platelet String Formation
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Von Willebrand factor and ADAMTS13 in arterial thrombosis: a systematic review and meta-analysis

Michelle A H Sonneveld1, Moniek P M de Maat1, Frank W G Leebeek1

  • 1Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.

Blood Reviews
|May 15, 2014
PubMed

Von Willebrand Factor (VWF) plays an important role in hemostasis by mediating platelet adhesion and aggregation. Ultralarge VWF multimers are cleaved by ADAMTS13 in smaller, less procoagulant forms. An association between high VWF levels and cardiovascular disease has frequently been reported, and more recently also an association has been observed between low ADAMTS13 levels and arterial thrombosis. We reviewed the current literature and performed meta-analyses on the relationship between both VWF and ADAMTS13 with arterial thrombosis. Most studies showed an association between high VWF levels and arterial thrombosis. It remains unclear whether ADAMTS13 is a causal independent risk factor because the association between low ADAMTS13 and arterial thrombosis is so far only shown in case-control studies. Prospective studies are awaited. A causal role for ADAMTS13 is supported by mice studies of cerebral infarction where the infusion of recombinant human ADAMTS13 reduced the infarct size.

Keywords:
ADAMTS13Coronary heart diseaseIschemic strokeMyocardial infarctionvon Willebrand factor

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