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 VTrisk in women.
Aims: To evaluate if the interaction of low ADAMTS13 levels and high vWf levels 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 (≤0,59 µg/mL) and P90 (>183% fvW) respectively. The VT risk was estimated with binary logistic regression. We estimated the crude and age-adjusted odds ratio. To assess interaction effect between vWf and ADAMTS13 two multivariate analysis (one for men and one for women) were performed, both models included the following variables: Age, vWf and ADAMTS13 levels as continuous variables and their product as interaction effect between the two markers.
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. However, when this relationship was analyzed by sex, a remarkably increased OR was found in women with low ADAMTS13 levels (adj-OR: 51.5 [6.81-390 95%CI], p<0.0001): Table 1
|TOTAL||ORcrude (95%CI)||ORadjusted (95%CI)|
|ADAMTS13<0,59 (ug/ml)||Women||51||27.07 (5.6-129)*||51.5 (6.81-390)*|
|ADAMTS13<0.59 (ug/ml)||Men||42||10.94 (3.06-39.01)*||8.21 (2.19-30.7)*|
|ADAMTS13>0.59 (ug/ml)||Women||358||10.85 (6.06-19.42)*||6.68 (3.6-12.4)*|
|ADAMTS13>0.59 (ug/ml)||Men||328||10.93 (5.91-20.21)*||7.61 (4.01-14.4)*|
The interaction effect between ADAMTS13 and vWf levels for the VT outcome was statistically significant in women (p= 0.044) but not in men (p= 0.943).
Conclusions: In the RETROVE project, the interaction between low ADAMTS13 levels and high von Willebrand factor levels seems to be related to a very high risk of VT in women.
To cite this abstract in AMA style:Llobet D, Vallvé C, Mojal S, Carrasco M, Vilalta N, Mateo J, Corrochano M, Millón JA, Souto JC. Interaction between the Von Willebrand Factor and ADAMTS13 on VTE Risk in Women. Results from the Retrove Project [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/interaction-between-the-von-willebrand-factor-and-adamts13-on-vte-risk-in-women-results-from-the-retrove-project/. Accessed September 16, 2021.
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