Von Willebrand Factor and ADAMTS13 in Cardiovascular Disease

Von Willebrand Factor plays an important role in primary hemostasis by platelet adhesion and aggregation. High molecular weight VWF multimers are the most procoagulant forms and are cleaved by ADAMTS13 (A Disintegrin And Metalloprotease with ThromboSpondin motif repeats 13) into smaller, less coagulant, forms.

Recent studies have shown an association between both high VWF levels, low ADAMTS13 levels and arterial thrombosis, including ischemic stroke and acute coronary syndrome. In this thesis several studies on VWF, ADAMTS13 and arterial thrombosis have been presented.

We conclude that the extent of atherosclerosis is strongly associated with VWF levels. Furthermore, VWF might be a marker of an unfavorable outcome in coronary heart disease and ischemic stroke patients. Plaque characteristics, such as high risk lesions, do not seem to be associated with VWF levels. Lastly, low ADAMTS13 is strongly associated with an increased risk of arterial thrombosis, including ischemic stroke and coronary heart disease. Overall, the studies in this thesis provide a better understanding of the role of VWF and ADAMTS13 in arterial thrombosis.