title: The role of von Willebrand factor and ADAMTS13 in the no-reflow phenomenon: after primary percutaneous coronary intervention.
abstract: We prospectively studied the correlations between plasma levels of von Willebrand factor and its cleaving protease--a disintegrin and metalloproteinase with thrombospondin type I motif, member 13 (ADAMTS13)--in 126 patients who did or did not develop no-reflow phenomenon after primary percutaneous intervention for acute ST-segment-elevation myocardial infarction. Quantitative plasma levels of von Willebrand factor and ADAMTS13 were measured by immunoturbidometric assay.Angiographic no-reflow was observed in 46 (37%) of the 126 patients. At admission, plasma levels of von Willebrand factor were significantly higher in the no-reflow group (P < 0.001), but levels of ADAMTS13 at admission were similar in the 2 groups (P = 0.143). At logistic regression, after adjustment for serum creatinine, left ventricular ejection fraction, high-sensitivity C-reactive protein, and N-terminal pro B-type natriuretic peptide, plasma von Willebrand factor level at admission (≥ 5,531 mU/mL) was still the predictive factor for the no-reflow phenomenon. The area under the receiver operating characteristics curve was 0.785.Our results suggest that high von Willebrand factor level is related to the no-reflow phenomenon in such a way that it might be a predictor of the phenomenon.
authors.affiliation: Department of Cardiology, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China.
authors.forename: Bilian
authors.initials: B
authors.lastname: Zhao
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Xinping
authors.initials: X
authors.lastname: Luo
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhou
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.forename: Haiming
authors.initials: H
authors.lastname: Shi
mesh_terms: D051722:ADAM Proteins / Q000097:blood*; D000071120:ADAMTS13 Protein; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002681:China; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology*; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human