title: Low ADAMTS-13 activity and the risk of coronary heart disease - a prospective cohort study: the Rotterdam Study.
abstract: Essentials An association between ADAMTS-13 and coronary heart disease (CHD) has been suggested. 5688 participants ≥ 55 years from the Rotterdam Study without a history of CHD were included. Over a median follow-up time of 9.7 years, 456 individuals suffered from CHD. Low ADAMTS-13 activity was associated with an increased CHD risk.
  
  
  
  Background The metalloprotease ADAMTS-13 cleaves high-molecular-weight von Willebrand factor multimers into smaller, less procoagulant forms. Low ADAMTS-13 activity is associated with an increased risk of ischemic stroke but its pathogenic role in coronary heart disease (CHD) is unclear. Objectives We aimed to determine the association between ADAMTS-13 activity and the risk of CHD in a large prospective population-based cohort study. Methods A total of 5688 participants of the Rotterdam Study, a population-based cohort study involving individuals aged ≥ 55 years without a history of CHD, were included. ADAMTS-13 activity was measured by the FRETS-VWF73 assay and VWF:Ag levels by ELISA. We assessed the association between ADAMTS-13 activity, VWF:Ag levels and CHD using Cox proportional hazard regression analysis, adjusting for cardiovascular risk factors. Results Over a median follow-up time of 9.7 years, 456 individuals suffered from CHD. A low ADAMTS-13 activity (quartile 1) was associated with an increased CHD risk (HR 1.42, 95% CI 1.07-1.89) compared with the reference highest quartile. Conclusions Low ADAMTS-13 activity is associated with an increased risk of CHD in the elderly, independently of VWF and established cardiovascular risk factors.
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: M A H
authors: MA
authors: Sonneveld
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: M
authors: M
authors: Kavousi
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Department of Radiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: M A
authors: MA
authors: Ikram
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors: A
authors: A
authors: Hofman
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.|School of Medicine, Faculty of Health, Universidad Industrial de Santander, Bucaramanga, Colombia.
authors: O L
authors: OL
authors: Rueda Ochoa
authors: Baxalta Innovations, Vienna, Austria.
authors: P L
authors: PL
authors: Turecek
authors: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: O H
authors: OH
authors: Franco
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: F W G
authors: FW
authors: Leebeek
authors: Department of Hematology, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors: M P M
authors: MP
authors: de Maat
mesh_terms: D000071120:ADAMTS13 Protein / Q000378:metabolism*; D000368:Aged; D002545:Brain Ischemia / Q000473:pathology; D002319:Cardiovascular System; D003327:Coronary Disease / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000378:metabolism; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D014841:von Willebrand Factor; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human
keywords: ADAMTS-13 protein, human; coagulation; coronary disease; myocardial infarction; von Willebrand factor