Plasma ADAMTS-13 levels and the risk of myocardial infarction: an individual patient data meta-analysis

Maino, A., Siegerink, B., Lotta, L.A., Crawley, J.T.B., le Cessie, S., Leebeek, F.W.G., Lane, D. A., Lowe, G.D.O., Peyvandi, F. and Rosendaal, F.R. (2015) Plasma ADAMTS-13 levels and the risk of myocardial infarction: an individual patient data meta-analysis. Journal of Thrombosis and Haemostasis, 13(8), pp. 1396-1404. (doi: 10.1111/jth.13032) (PMID:26073931)

Abstract

Background Low ADAMTS-13 levels have been repeatedly associated with an increased risk of ischemic stroke, but results concerning the risk of myocardial infarction are inconclusive. Objectives To perform an individual patient data meta-analysis from observational studies investigating the association between ADAMTS-13 levels and myocardial infarction. Methods A one-step meta-analytic approach with random treatment effects was used to estimate pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) adjusted for confounding. Analyses were based on dichotomous exposures, with the 5th and 1st percentiles of ADAMTS-13 antigen levels as cut-off values. Quartile analyses, with the highest quartile as a reference category, were used to assess a graded association between levels and risk (‘dose’ relationship). Additionally, we assessed the risk of the combined presence of low ADAMTS-13 and high von Willebrand factor (VWF) levels. Results Five studies were included, yielding individual data on 1501 cases and 2258 controls (mean age of 49 years). Low ADAMTS-13 levels were associated with myocardial infarction risk, with an OR of 1.89 (95% CI 1.15–3.12) for values below the 5th percentile versus above, and an OR of 4.21 (95% CI 1.73–10.21) for values below the 1st percentile versus above. Risk appeared to be restricted to these extreme levels, as there was no graded association between ADAMTS-13 levels and myocardial infarction risk over quartiles. Finally, there was only a minor synergistic effect for the combination of low ADAMTS-13 and high VWF levels. Conclusions Low ADAMTS-13 levels are associated with an increased risk of myocardial infarction.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lowe, Professor Gordon
• Authors: Maino, A., Siegerink, B., Lotta, L.A., Crawley, J.T.B., le Cessie, S., Leebeek, F.W.G., Lane, D. A., Lowe, G.D.O., Peyvandi, F., and Rosendaal, F.R.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of Thrombosis and Haemostasis
• Publisher: Blackwell Publishing
• ISSN: 1538-7933
• ISSN (Online): 1538-7836