ADAMTS‐13 and von Willebrand factor predict venous thromboembolism in patients with cancer

Essentials Cancer patients are at high risk of venous thromboembolism (VTE). In this study, cases and controls were cancer patients who did or did not develop VTE. von Willebrand factor (VWF) levels were higher if compared with controls and correlated with cancer stage. VWF and ADAMTS‐13 are associa...

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Published in:Journal of thrombosis and haemostasis 2016-02, Vol.14 (2), p.306-315
Main Authors: Pépin, M., Kleinjan, A., Hajage, D., Büller, H. R., Di Nisio, M., Kamphuisen, P. W., Salomon, L., Veyradier, A., Stepanian, A., Mahé, I.
Format: Article
Language:English
Subjects:
ADAMTS13 Protein - blood
ADAMTS‐13 protein, human
Aged
Area Under Curve
Biomarkers - blood
cancer
Case-Control Studies
D‐dimer
Europe
Female
Humans
Male
Mexico
Middle Aged
Neoplasm Staging
Neoplasms - blood
Neoplasms - complications
Neoplasms - diagnosis
Peptide Fragments - analysis
Predictive Value of Tests
Prognosis
Prospective Studies
Prothrombin - analysis
P‐selectin
Risk Assessment
Risk Factors
ROC Curve
thrombosis
Time Factors
Venous Thromboembolism - blood
Venous Thromboembolism - diagnosis
Venous Thromboembolism - etiology
von Willebrand factor
von Willebrand Factor - analysis
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Summary:Essentials Cancer patients are at high risk of venous thromboembolism (VTE). In this study, cases and controls were cancer patients who did or did not develop VTE. von Willebrand factor (VWF) levels were higher if compared with controls and correlated with cancer stage. VWF and ADAMTS‐13 are associated with the occurrence of VTE in cancer. Summary Background Patients with cancer are at high risk of venous thromboembolism (VTE). ADAMTS‐13 regulates von Willebrand factor (VWF) activity, which plays a role in the development of cancer and in VTE. Objectives The aim of this study was to search for an association between the levels of VWF and ADAMTS‐13 and VTE in patients with cancer and to compare current scoring systems for prediction of VTE before and after addition of these parameters. Patients/Methods In a case–control study, in which patients with recently diagnosed cancer were followed‐up for 6 months, we compared 20 patients who developed VTE (cases) and 140 patients with cancer without VTE (controls), matched for sex, age, and type and stage of cancer. We measured VWF, ADAMTS‐13 (activity and antigen), P‐selectin, D‐dimer and F1 + 2 levels at baseline, and calculated both the Khorana score and the Khorana score expanded after addition of P‐selectin and D‐dimer levels. Results VWF levels were significantly higher in cases when compared with controls (326 ± 185% vs. 242 ± 158%) and correlated with advanced stage of cancer: localized, 185 [142; 222]; locally advanced, 240 [146; 257]; metastatic, 267 [153; 324] (mean [interquartile range]). The addition of two biomarkers, ADAMTS‐13 activity and F1 + 2 levels, to the Khorana score improved receiver operating curves. Conclusions von Willebrand factor and ADAMTS‐13 are associated with the occurrence of VTE in patients with cancer. Moreover, addition of ADAMTS‐13 and F1 + 2 levels to the Khorana score considerably increases the predictive value for VTE.
ISSN:1538-7933
1538-7836
1538-7836
DOI:10.1111/jth.13205