Levels of von Willebrand factor and ADAMTS13 determine clinical outcome after cardioversion for atrial fibrillation
| Autor: | Veronika Bruno, Thomas Höchtl, Rudolf Jarai, Susanne C. Gruber, Serdar Farhan, Ivan Brozovic, Kurt Huber, Johann Wojta, Matthias K. Freynhofer |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Risk medicine.medical_specialty Heart disease medicine.medical_treatment Electric Countershock ADAMTS13 Protein Cardioversion Von Willebrand factor Predictive Value of Tests Recurrence hemic and lymphatic diseases Internal medicine Atrial Fibrillation von Willebrand Factor medicine Humans Endothelial dysfunction Thrombus Aged biology business.industry Confounding Atrial fibrillation Hematology Middle Aged medicine.disease ADAMTS13 ADAM Proteins Treatment Outcome Endocrinology Gene Expression Regulation biology.protein Cardiology Female Endothelium Vascular business |
| Zdroj: | Thrombosis and Haemostasis. 105:435-443 |
| ISSN: | 2567-689X 0340-6245 |
| DOI: | 10.1160/th10-09-0615 |
| Popis: | SummaryVon Willebrand factor (vWF) plays an essential role in platelet adhesion and thrombus formation. Patients with atrial fibrillation (AF) exhibit higher plasma vWF and lower ADAMTS13 antigen levels compared to controls. Little is known about vWF and ADAMTS13 in AF patients treated with cardioversion (CV). Thus we investigated the alterations of plasma vWF and ADAMTS13 after CV and evaluated the predictive value of these parameters for recurrence of AF. In this observational study we determined plasma levels of vWF and ADAMTS13 in 77 patients before and immediately after CV, as well as 24 hours (h) and six weeks thereafter, by means of commercially available assays. The vWF/ ADAMTS13-ratio was significantly elevated immediately after CV (p=0.02) and 24 h after CV (p=0.002) as compared to baseline levels. ADAMTS13, 24 h after CV, exhibited a significant association with recurrence of AF (HR: 0.97; p=0.037). Accordingly, tertiles of ADAMTS13 showed a stepwise inverse correlation with the risk of recurrent AF (HR: 0.50; p=0.009). After adjustment for confounders, ADAMTS13 remained significant as an independent predictor of recurrent AF (HR: 0.61; p=0.047). Similarly, the vWF/ADAMTS13-ratio, 24 h after CV, was associated with rhythm stability and remained an independent predictor of recurrent AF (HR: 1.88; p=0.028). The regulation of vWF and its cleaving protease ADAMTS13 after CV might play a critical role in producing a pro-thrombotic milieu immediately after CV for AF. Since ADAMTS13 plasma concentration and the vWF/ADAMTS13-ratio are independently associated with rhythm stability, these indexes might be used for prediction of recurrence of AF. |
| Databáze: | OpenAIRE |
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