Evidence that high von Willebrand factor and low ADAMTS-13 levels independently increase the risk of a non-fatal heart attack.
BACKGROUND
A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS-13) may influence von Willebrand factor (VWF) levels and consequently the risk of myocardial infarction (MI). Moreover, ADAMTS-13 influences hemostatic plug formation in mouse models. We therefore studied their associations in the Glasgow MI Study (GLAMIS).


RESULTS
We measured ADAMTS-13 and VWF antigen levels by ELISAs in stored plasma from a case-control study of 466 MI cases and 484 age- and sex-matched controls from the same north Glasgow population. There was no correlation between ADAMTS-13 and VWF levels in cases or controls. ADAMTS-13 levels correlated positively with serum cholesterol and triglycerides and body mass index, and negatively with high-density lipoprotein-cholesterol. VWF levels correlated with age, fibrinogen and C-reactive protein. In multivariable analyses including risk factors, VWF correlated positively with risk of MI, and ADAMTS-13 correlated negatively with risk of MI. These associations were independent of each other. The association of ADAMTS-13 with risk of MI was observed only in multivariable analysis.


CONCLUSIONS
VWF and ADAMTS-13 levels were not associated in this study, and showed associations with MI risk in opposite directions but of similar strength. The association of ADAMTS-13 with MI is influenced by lipid levels, and consequently requires further investigation.
Crawley
J T B
JT
Department of Haematology, Imperial College London, London, UK. j.crawley@imperial.ac.uk
Lane
D A
DA
Woodward
M
M
Rumley
A
A
Lowe
G D O
GD
D051722:ADAM Proteins / Q000172:deficiency*; D000071120:ADAMTS13 Protein; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000201:enzymology / Q000453:epidemiology*; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood*; D014841:von Willebrand Factor / Q000032:analysis*
D008076:Cholesterol, HDL; D014280:Triglycerides; D014841:von Willebrand Factor; D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human