ADAMTS-13 in Critically Ill Patients With Septic Syndromes and Noninfectious Systemic Inflammatory Response Syndrome

Aibar, Jesús; Castro, Pedro; Espinosa, Gerard; Fernández, Sara; Hernández, Cristina; Rinaudo, Mariano; Butjosa, Montserrat; Tàssies, Dolors; Reverter, Joan Carles; Nicolás, Josep M.

doi:10.1097/shk.0000000000000341

Cited by 36 publications

(43 citation statements)

References 26 publications

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“…VWF/ADAMTS‐13 system disorders in sepsis have been associated with disease severity and increased mortality . Particularly, in critically ill patients with severe sepsis or septic shock, ADAMTS‐13 levels were lower than in ICU patients without sepsis; in the same study, decreased ADAMTS‐13 levels were associated with increased APACHE II score at admission and predicted an increased risk of death in ICU …”

Section: Discussionmentioning

confidence: 72%

Variation of endothelium‐related hemostatic factors during sepsis

Vasileiadis

Politou

Dimopoulos³

et al. 2018

Microcirculation

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Section: Discussionmentioning

confidence: 72%

Variation of endothelium‐related hemostatic factors during sepsis

Vasileiadis

Politou

Dimopoulos³

et al. 2018

Microcirculation

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“…A recently published paper by Aibar et al [17] showed a negative correlation between ADAMTS13 levels and APACHE II scores. Whereas Aibar et al included patients varying from SIRS without infection to sepsis, our study included patients with severe sepsis and septic shock.…”

Section: Discussionmentioning

confidence: 95%

“…The purpose of this study was to confirm that ADAMTS13 levels could be used to predict mortality in patients with severe sepsis and septic shock. Two studies have reported decreased levels of ADAMTS13 level in patients with severe sepsis and septic shock and its relationship with mortality [17,18]; however, the predictive value of serial samples of ADAMTS13 in patients with severe sepsis and septic shock have not been reported. Our study also compared ADAMTS13 levels with APACHE II scores, as predictors of mortality in patients with severe sepsis and septic shock.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of ADAMTS13 in patients with severe sepsis and septic shock

Azfar

Khan

Habib

et al. 2017

CIM

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Prognostic value of ADAMTS13 in patients with severe sepsis and septic shock Abstract Purpose: ADAMTS13 level was evaluated as a predictor of mortality in patients with severe sepsis and septic shock, and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores.Methods: This prospective observational study was conducted in the Medical and Surgical Intensive Care Units of King Khalid University Hospital. Detailed clinical evaluations were performed on 84 patients (56.08±18.18 years of age) with severe sepsis and septic shock. ADAMTS13 levels were determined (three blood samples at 24 hours intervals) and APACHE II scores, hematological profiles, indices of organ hypo-perfusion, renal functions and coagulation profiles were recorded. Primary outcome was 30 days ICU mortality and secondary outcomes were its comparison with APACHE II score, length of ICU stay and use of vasopressor agents.Results: Hypertension (53.6%) and diabetic mellitus (45.2%) were the commonest comorbidities. The median ADAMTS13 levels were 336.65, 339.35 and 313.9, respectively. ROC analysis showed maximum area under the curve for second ADAMTS13 (AUC=0.760) compared with first (AUC=0.660) and third samples (AUC=0.707) and APACHE II scores (AUC=0.662). Patients were divided into low and high ADAMTS13 groups according to the best cut-off point. Mortality was high in the low ADAMTS13 level group [OR=4.5]and was significantly associated with age, DBP, ADAMTS13, APACHE II score, DIC score and platelet count. ADAMTS13 (OR=5.3), APACHE II (OR=4.13) and DIC scores (OR=7.32) were significant risk factors for mortality.Conclusions: Low ADAMTS13 was associated with increased mortality in patients with severe sepsis and septic shock and was comparable to APACHE II scores for predicting mortality.

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“…In this view, it is interesting to observe how in clinical studies on patients with SIRS and sepsis, VWF and ADAMTS13 have shown to be a prognostic biomarker identifying patients with worse outcome and a higher risk of death [86–88]. The ADAMTS13 pattern also differed in infective (sepsis) or noninfective SIRS [89]: septic patients have lower levels of ADAMTS13 than patients with noninfectious SIRS. These studies together bring new lights on the link between thrombosis, inflammation, and infective diseases.…”

Section: Vwf Tma and Infective Disease: Cross-talk Between Infecmentioning

confidence: 99%

The Role of von Willebrand Factor in Vascular Inflammation: From Pathogenesis to Targeted Therapy

Gragnano

Sperlongano

Golia

et al. 2017

Mediators of Inflammation

168

159

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Beyond its role in hemostasis, von Willebrand factor (VWF) is an emerging mediator of vascular inflammation. Recent studies highlight the involvement of VWF and its regulator, ADAMTS13, in mechanisms that underlie vascular inflammation and immunothrombosis, like leukocyte rolling, adhesion, and extravasation; vascular permeability; ischemia/reperfusion injury; complements activation; and NETosis. The VWF/ADAMTS13 axis is implicated in the pathogenesis of atherosclerosis, promoting plaque formation and inflammation through macrophage and neutrophil recruitment in inflamed lesions. Moreover, VWF and ADAMTS13 have been recently proposed as prognostic biomarkers in cardiovascular, metabolic, and inflammatory diseases, such as diabetes, stroke, myocardial infarction, and sepsis. All these features make VWF an attractive therapeutic target in thromboinflammation. Several lines of research have recently investigated “tailor-made” inhibitors of VWF. Results from animal models and clinical studies support the potent anti-inflammatory and antithrombotic effect of VWF antagonism, providing reassuring data on its safety profile. This review describes the role of VWF in vascular inflammation “from bench to bedside” and provides an updated overview of the drugs that can directly interfere with the VWF/ADAMTS13 axis.

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ADAMTS-13 in Critically Ill Patients With Septic Syndromes and Noninfectious Systemic Inflammatory Response Syndrome

Cited by 36 publications

References 26 publications

Variation of endothelium‐related hemostatic factors during sepsis

Variation of endothelium‐related hemostatic factors during sepsis

Prognostic value of ADAMTS13 in patients with severe sepsis and septic shock

The Role of von Willebrand Factor in Vascular Inflammation: From Pathogenesis to Targeted Therapy

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