TITLE:
Assessment of the Diagnostic Value of Plasma Level of Von Willebrand Factor and ADAMTS13 in Patients with Cerebral Infarction
AUTHORS:
Basant Magdy Abdulla, Aziza Abbas Ahmed, Dalia Mahmoud Eldawy, Lamiaa Ismail Ahmed
KEYWORDS:
VWF, ADAMTS13, Cerebral Infarction
JOURNAL NAME:
Open Journal of Blood Diseases,
Vol.12 No.4,
December
12,
2022
ABSTRACT: Background: Von Willebrand Factor (VWF) is a large multimeric
plasma gly-coprotein that plays an important role in primary haemostasis. VWF
together with ADAMTS13 plays a key role in arterial thrombosis. VWF is integral
for platelet adhesion to collagen fibres and atherosclerotic plaues and platelets
aggregation under high shear conditions. Upon vascular wall damage, plasma VWF
binds to collagen in the exposed endothelial matrix and platelet glycoprotein
triggers platelet aggregation and thrombous formation. In the early stages of acute
ischaemic stroke, VWF increased significantly and the ADAMTS13 level decreased.
The increase of plasma VWF and FVIII in a patient with ischaemic stroke indicated an increased
risk of complications and severe neurological deficit. Objective: to evaluate the validity of VWF and ADFAMTS13 as
diagnostic markers of cerebral infarction by comparing the two markers’ validity in diagnosis. Methods: this case
control study enrolled 38 cerebral infarction patients 20 acute infarction and 18
recurrent infarction. Patients were compared with 65 age and sex with control
patients. We performed the VWF assay using the minividas immunofluorescence technique and the ADAMTS13 assay using the ELISA technique. Results: VWF level of acute infarction patients (280.97 ± 109.83 IU/dl) while its
level in recurrent infarction (264.93 ± 172.8 IU/dl) were highly significantly increased compared to
control (75.8 ± 16.24 IU/dl). ADAMTS13 level of acute infarction patients was
(506.11 ± 225.24 ng/dl) and (1386.03 ± 667.64 ng/dl) in recurrent infarction
patients with
highly significant differences between the acute and control group and non-significant different between recurrent and control. ADAMTS13 is an
excellent diagnostic test in acute cerebral infarction but a weak diagnostic test in
recurrent cerebral infarction but it is a good diagnostic test in
differentiation between acute and recurrent cerebral infarction patients. VWF is an excellent
diagnostic test in both acute and recurrent cases. In acute infarction, VWF is positively correlated
with kidney function while ADAMTS13 level did not correlate with different
laboratory parameters in recurrent infarction. A positive
correlation is present between ADAMTS13 and PT & PTT concentration. No correlation
exists between VWF & ADAMTS13 in the 3 groups. Conclusion: ADAMTS13
is closely related to the occurrence, development and progression of acute cerebral
infarction, protecting the brain from ischaemic reperfusion injury. It is an excellent diagnostic test in acute cerebral infarction but a weak diagnostic test in recurrent cerebral
infarction while VWF is an excellent diagnostic test in acute & recurrent
cerebral infarction. ADAMTS13 is expected to become a new therapeutic agent in
acute cerebral infarction patients.