RESUMO
Essentials An association between ADAMTS-13 and coronary heart disease (CHD) has been suggested. 5688 participants ≥ 55 years from the Rotterdam Study without a history of CHD were included. Over a median follow-up time of 9.7 years, 456 individuals suffered from CHD. Low ADAMTS-13 activity was associated with an increased CHD risk. SUMMARY: Background The metalloprotease ADAMTS-13 cleaves high-molecular-weight von Willebrand factor multimers into smaller, less procoagulant forms. Low ADAMTS-13 activity is associated with an increased risk of ischemic stroke but its pathogenic role in coronary heart disease (CHD) is unclear. Objectives We aimed to determine the association between ADAMTS-13 activity and the risk of CHD in a large prospective population-based cohort study. Methods A total of 5688 participants of the Rotterdam Study, a population-based cohort study involving individuals aged ≥ 55 years without a history of CHD, were included. ADAMTS-13 activity was measured by the FRETS-VWF73 assay and VWF:Ag levels by ELISA. We assessed the association between ADAMTS-13 activity, VWF:Ag levels and CHD using Cox proportional hazard regression analysis, adjusting for cardiovascular risk factors. Results Over a median follow-up time of 9.7 years, 456 individuals suffered from CHD. A low ADAMTS-13 activity (quartile 1) was associated with an increased CHD risk (HR 1.42, 95% CI 1.07-1.89) compared with the reference highest quartile. Conclusions Low ADAMTS-13 activity is associated with an increased risk of CHD in the elderly, independently of VWF and established cardiovascular risk factors.
Assuntos
Proteína ADAMTS13/metabolismo , Doença das Coronárias/diagnóstico , Fator de von Willebrand/metabolismo , Idoso , Isquemia Encefálica/patologia , Sistema Cardiovascular , Doença das Coronárias/metabolismo , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Países Baixos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/metabolismoRESUMO
La mayor frecuencia de eventos cardiovasculares, incluyendo isquemia, infarto comprobado y fallecimiento de origen cardiovascular se observa en las horas de la mañana. Se revisaron las historias clínicas de los pacientes atendidos en los servicios de urgencias de cuatro hospitales universitarios con diagnóstico de egreso de un evento cardiovascular. El diseño del formulario permitía detectar la hora de inicio del evento, la hora de consulta, la evolución del paciente de acuerdo con la severidad del cuadro clínico. La mayoría de infartos eran de primera vez, y los eventos fueron significativamente más frecuentes los días domingo, lunes y jueves y durante los meses de julio a septiembre