High VWF, low ADAMTS13, and oral contraceptives increase the risk of ischemic stroke and myocardial infarction in young women

被引:115
作者
Andersson, Helena M. [1 ]
Siegerink, Bob [2 ]
Luken, Brenda M. [1 ]
Crawley, James T. B. [1 ]
Algra, Ale [2 ,3 ,4 ]
Lane, David A. [1 ]
Rosendaal, Frits R. [2 ,5 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Ctr Haematol, Fac Med, London W12 0NN, England
[2] Leiden Univ, Dept Clin Epidemiol, Med Ctr, Leiden, Netherlands
[3] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands
[4] Univ Med Ctr Utrecht, Dept Neurol & Neurosurg, Utrecht Stroke Ctr, Utrecht, Netherlands
[5] Leiden Univ, Dept Thrombosis & Hemostasis, Med Ctr, Leiden, Netherlands
关键词
VON-WILLEBRAND-FACTOR; WEIBEL-PALADE BODIES; ARTERIAL THROMBOSIS; MARKERS; RATIO; CORONARY; DISEASE; PROTEIN; INFLAMMATION; ACTIVATION;
D O I
10.1182/blood-2011-09-380618
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
VWF and ADAMTS13 are major determinants of platelet adhesion after vessel injury. In the present study, we aimed to determine whether VWF or ADAMTS13 plasma antigen levels influence the risks of ischemic stroke (IS) or myocardial infarction (MI) in young women and how these risks are affected by oral contraceptive (OC) use. VWF and ADAMTS13 plasma antigen levels were measured in a frequency-matched case-control study of 1018 young (18-49 years) women including 175 IS patients and 205 MI patients. Increasing levels of VWF and decreasing levels of ADAMTS13 were associated with the risk of IS and MI in a dose-dependent manner. Having both high VWF and low ADAMTS13 resulted in an odds ratio (OR) of 6.9 (95% confidence interval [95% CI], 2.0-23.0) for IS and 11.3 (95% CI, 3.6-35.2) for MI. Use of OCs increased the risk of IS and MI associated with high VWF (OR = 12; 95% CI, 5.5-26.2 and OR = 7.5, 95% CI, 3.6-15.7, respectively) and the risk of IS associated with low ADAMTS13 (OR = 5.8, 95% CI, 2.7-12.4). We conclude that high VWF and low ADAMTS13 plasma levels both increase the risk of IS and MI. The risks associated with high VWF or low ADAMTS13 levels are further increased by the use of OCs. (Blood. 2012;119(6):1555-1560)
引用
收藏
页码:1555 / 1560
页数:6
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