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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 and long-term outcomes in patients undergoing percutaneous coronary intervention

Maximilian Tscharre1, Ioannis Tentzeris2, Birgit Vogel2

  • 13rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria; Institute of Cardiometabolic Diseases, Karl Landsteiner Society, St. Pölten, Austria.

Thrombosis Research
|August 24, 2020
PubMed

Insights

Von Willebrand factor (VWF) is linked to major adverse cardiovascular events and death in acute coronary syndrome patients after PCI. ADAMTS13 did not show predictive value in this patient group.

Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Von Willebrand factor (VWF) and ADAMTS13 are key in thrombosis and atherosclerosis.
  • Their role in major adverse cardiovascular outcomes (MACE) post-percutaneous coronary intervention (PCI) requires investigation.

Purpose of the Study:

  • To assess the impact of VWF, ADAMTS13, and their ratio on long-term MACE in patients undergoing PCI.
  • To determine the predictive value of VWF and ADAMTS13 for mortality in this cohort.

Main Methods:

  • Analysis of 701 patients undergoing PCI (2003-2006).
  • Measurement of pre-PCI VWF and ADAMTS13 antigen levels.
  • Primary endpoint: MACE (all-cause mortality, myocardial infarction, ischemic stroke) over 8 years.
  • Secondary endpoint: All-cause mortality.

Main Results:

  • In patients with acute coronary syndrome (ACS), VWF levels significantly predicted MACE (HR 1.402) and all-cause death (HR 1.841).
  • ADAMTS13 and VWF/ADAMTS13 ratio showed no predictive value for MACE or mortality in ACS patients.
  • Neither VWF, ADAMTS13, nor their ratio correlated with MACE or mortality in patients with stable coronary artery disease (SCAD).

Conclusions:

  • VWF is a significant predictor of MACE and mortality in ACS patients post-PCI.
  • ADAMTS13 and the VWF/ADAMTS13 ratio do not appear to be useful markers for risk stratification in this population.
  • VWF emerges as a crucial risk marker specifically for patients with ACS undergoing PCI.
Abstract

Keywords:
ADAMTS13Long-term outcomesPercutaneous coronary interventionVWFVWF/ADAMTS13

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