PB0952 - The von Willebrand Factor / ADAMTS13 ratio is a good indicator of venous thromboembolism risk. Results from the RETROVE project.

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

DL

Dolors Llobet, PhD

Biologist
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain

Co-Author(s)

CV

Cristina Vallvé

lab technician
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
SM

Sergi Mojal

Statistical analysis
Intitut d’Investigacions Biomèdiques Sant Pau (IIB-Sant Pau), Barcelona, Spain
BARCELONA, Catalonia, Spain
MC

Marina Carrasco

Doctor
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
NV

Noèlia Vilalta

Doctor
Unitat d'Hemostàsia i Trombosi. Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
JM

José Mateo

Doctor
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
JM

Juan Millón

Doctor
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
JS

Juan Carlos Souto

Doctor
Thrombosis and Haemostasis Unit, Hospital de la Santa Creu i Sant Pau and Intitut d’Investigacions Biomèdiques Sant Pau (IIB-Sant Pau), Barcelona, Spain.
Barcelona, Catalonia, Spain

Background: High von Willebrand factor (vWf) levels are a known risk factor of venous thrombosis (VT). ADAMTS13 is the regulator of vWf. Recently, our group has described that low ADAMTS13 levels are associated with VT risk in women. Also, Pagliari, et al. reported that ADAMTS13 activity levels < 86% are associated with a moderate risk of VT. Lastly, it has been recently described in several studies about ADAMTS 13 levels and COVID, they found that a high vWf/ADAMTS13 ratio is associated with a higher severity of COVID and also that low ADAMTS13 is associated with lower survival.

Aims: To evaluate if the vWf/ADAMTS13 ratio increases VT risk.

Methods: Patients consisted of 400 individuals with VT recruited by the RETROVE Project (Riesgo de Enfermedad TROmboembólica VEnosa). Also, 400 healthy controls were included. Controls were not matched for sex or age due to the design of the project. We determined antigen ADAMTS13 and vWf by ELISA and their cut-off points were set at P10 (≤60% ADAMTS13) and P90 (>183% fvW) respectively. The VT risk was estimated with binary logistic regression. We estimated the crude and age-adjusted odds ratio.

Results: vWf levels above 183% were associated with higher VT risk (adj-OR: 8.48 [5.48-13.12 95%CI], p< 0.001). Also, high ORs were found with vWf>183% regardless of ADAMTS13 levels, suggesting that vWf is the main factor responsible for VT risk. A synergetic effect of high vWf levels plus low ADAMTS13 levels were found, the adj-OR increases to 13.47 ([5.10-35.53], p=0.0001) when low ADAMTS13 levels were included in the calculations.

Regarding the behavior of vWf/ADAMTS13 ratio, we found the following results (Table 1) :

Conclusion(s): In the RETROVE project, the von Willebrand Factor / ADAMTS13 ratio is a good indicator of venous thromboembolism risk.

Spanish grants:FIS PI12/00612, FIS PI 15/00269, and FIS PI 18/00434