BackgroundLow ADAMTS-13 levels have been repeatedly associated with an increased risk of ischemic stroke, but results concerning the risk of myocardial infarction are inconclusive. ObjectivesTo perform an individual patient data meta-analysis from observational studies investigating the association between ADAMTS-13 levels and myocardial infarction. MethodsA 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. ResultsFive studies were included, yielding individual data on 1501 cases and 2258 controls (mean age of 49years). Low ADAMTS-13 levels were associated with myocardial infarction risk, with an OR of 1.89 (95%CI1.15-3.12) for values below the 5th percentile versus above, and an OR of 4.21 (95%CI1.73-10.21) 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. ConclusionsLow ADAMTS-13 levels are associated with an increased risk of myocardial infarction.
Plasma ADAMTS-13 levels and the risk of myocardial infarction: an individual patient data meta-analysis / A. Maino, B. Siegerink, L.A. Lotta, J.T. Crawley, S. le Cessie, F.W. Leebeek, D.A. Lane, G.D. Lowe, F. Peyvandi, F.R. Rosendaal. - In: JOURNAL OF THROMBOSIS AND HAEMOSTASIS. - ISSN 1538-7836. - 13:8(2015), pp. 1396-1404. [10.1111/jth.13032]
Plasma ADAMTS-13 levels and the risk of myocardial infarction: an individual patient data meta-analysis
F. PeyvandiPenultimo
;
2015
Abstract
BackgroundLow ADAMTS-13 levels have been repeatedly associated with an increased risk of ischemic stroke, but results concerning the risk of myocardial infarction are inconclusive. ObjectivesTo perform an individual patient data meta-analysis from observational studies investigating the association between ADAMTS-13 levels and myocardial infarction. MethodsA 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. ResultsFive studies were included, yielding individual data on 1501 cases and 2258 controls (mean age of 49years). Low ADAMTS-13 levels were associated with myocardial infarction risk, with an OR of 1.89 (95%CI1.15-3.12) for values below the 5th percentile versus above, and an OR of 4.21 (95%CI1.73-10.21) 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. ConclusionsLow ADAMTS-13 levels are associated with an increased risk of myocardial infarction.File | Dimensione | Formato | |
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