The Relationship between Plasma ADAMTS13 Levels and Clinical Prognosis in Heart Failure Patients with Type 2 Diabetes Mellitus

Zhenzhen LIU; Ying ZHANG; Xinyu GAO

doi:10.12259/j.issn.2095-610X.S20250713

Volume 46 Issue 7

Jul. 2025

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Zhenzhen LIU, Ying ZHANG, Xinyu GAO. The Relationship between Plasma ADAMTS13 Levels and Clinical Prognosis in Heart Failure Patients with Type 2 Diabetes Mellitus[J]. Journal of Kunming Medical University, 2025, 46(7): 110-117. doi: 10.12259/j.issn.2095-610X.S20250713

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Zhenzhen LIU, Ying ZHANG, Xinyu GAO. The Relationship between Plasma ADAMTS13 Levels and Clinical Prognosis in Heart Failure Patients with Type 2 Diabetes Mellitus[J]. Journal of Kunming Medical University, 2025, 46(7): 110-117. doi: 10.12259/j.issn.2095-610X.S20250713

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The Relationship between Plasma ADAMTS13 Levels and Clinical Prognosis in Heart Failure Patients with Type 2 Diabetes Mellitus

doi: 10.12259/j.issn.2095-610X.S20250713

Department of Cardiology，The First Affiliated Hospital of Xi'an Jiaotong University，Yulin Hospital，Yulin Shaanxi 719000，China

Received Date: 2025-05-07
Publish Date: 2025-07-21

Abstract

Abstract

objective To investigate the prognostic value of plasma ADAMTS13 in patients with heart failure complicated with type 2 diabetes mellitus （T2DM）. Methods Clinical data were collected from adult patients with acute decompensated heart failure admitted to the Second People's Hospital of Yulin City from January 2019 to December 2020, with a total of 278 cases included. The level of ADAMTS13 was measured using an ELISA kit, and patients were divided into three groups based on the third quartile of ADAMTS13 : T1<9.9 μg/L group （n = 92）, T2 ≥ 10.0-18.5 μg/L group （n = 93）, and T3 ≥ 18.5 μg/L group （n = 93）. The primary outcome was defined as the composite end point of all-cause mortality's or heart failure readmission. Secondary outcomes included all-cause mortality and heart failure readmission. Results Compared with the patients in the highest third quartile of ADAMTS13, the number of T2DM cases, body mass index, uric acid, fasting blood glucose, HbA1c and hs-CRP levels in the patients with the lowest third quartile of ADAMTS13 increased significantly （P < 0.05）. The absolute risks of main outcome, all-cause death and hospitalization of heart failure were higher in T2DM patients than in non-T2DM patients （χ² = 12.028, 8.725, 9.023, all P = 0.000）. The differences in heart failure rate among patients with different ADAMTS13 levels were statistically significant （χ² = 9.384, P = 0.002）. Every doubling of ADAMTS13 was related to a decreased risk of the main outcomes in HF patients with T2DM （HR=0.69, 95%CI=0.61～0.79）, all-cause mortality （HR=0.59, 95%CI=0.47～0.74） and heart failure readmission （HR=0.75, 95%CI=0.65～0.87）. Conclusion ADAMTS13 is an independent biomarker for risk stratification in HF, especially in patients with T2DM.
- A disintegrin-like and metalloprotease with thrombospondin type 1 repeats-13,
- Heart failure,
- Type 2 diabetes mellitus,
- Prognosis

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References(26)

References

[1]	Marco A,Marco P. Von Willebrand factor and ADAMTS13 activity as clinical severity markers in patients with COVID-19[J]. J Thromb Thrombolysis,2021,52(2):497-503. doi: 10.1007/s11239-021-02457-9
[2]	South K,Saleh O,Lemarchand E,et al. Robust thrombolytic and anti-inflammatory action of a constitutively active ADAMTS13 variant in murine stroke models[J]. Blood,2022,139(10):1575-1587. doi: 10.1182/blood.2021012787
[3]	Warlo E M K,Bratseth V,Pettersen A R,et al. Genetic variation in ADAMTS13 is related to VWF levels,atrial fibrillation and cerebral ischemic events[J]. Clin Appl Thromb Hemost,2022,28: 10760296221141893.
[4]	Popa M,Hecker M,Wagner A H. Inverse regulation of confluence-dependent ADAMTS13 and von willebrand factor expression in human endothelial cells[J]. Thromb Haemost,2022,122(4):611-622.
[5]	Tordon B,Warkentin T E,Moore J C,et al. Post-cardiac surgery thrombotic thrombocytopenic Purpura: Presence of anti-ADAMTS13 autoantibodies at preoperative baseline[J]. Platelets,2022,33(3):479-483. doi: 10.1080/09537104.2021.1912314
[6]	Hung S Y,Lin T M,Liou H H,et al. Association between ADAMTS13 deficiency and cardiovascular events in chronic hemodialysis patients[J]. Sci Rep,2021,11(1):22816. doi: 10.1038/s41598-021-02264-5
[7]	Despa F,Goldstein L B. Amylin dyshomeostasis hypothesis: Small vessel-type ischemic stroke in the setting of type-2 diabetes[J]. Stroke,2021,52(6):e244-e249.
[8]	Lecoeur E,Domeng O,Fayol A,et al. Epidemiology of heart failure in young adults: A French nationwide cohort study[J]. Eur Heart J,2023,44(5):383-392. doi: 10.1093/eurheartj/ehac651
[9]	Lemesle G,Puymirat E,Bonello L,et al. Compared impact of diabetes on the risk of heart failure from acute myocardial infarction to chronic coronary artery disease[J]. Diabetes Metab,2022,48(1):101265. doi: 10.1016/j.diabet.2021.101265
[10]	Sharma A,Zheng Y,Ezekowitz J A,et al. Cluster analysis of cardiovascular phenotypes in patients with type 2 diabetes and established atherosclerotic cardiovascular disease: A potential approach to precision medicine[J]. Diabetes Care,2022,45(1):204-212. doi: 10.2337/dc20-2806
[11]	中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志,2018,46(10):760-789. doi: 10.3760/cma.j.issn.0253-3758.2018.10.004
[12]	Zierfuss B,Feldscher A,Höbaus C,et al. NT-proBNP as a surrogate for unknown heart failure and its predictive power for peripheral artery disease outcome and phenotype[J]. Sci Rep,2023,13(1):8029. doi: 10.1038/s41598-023-35073-z
[13]	Shahriari M H,Sabbaghi H,Asadi F,et al. Artificial intelligence in screening,diagnosis,and classification of diabetic macular edema: A systematic review[J]. Surv Ophthalmol,2023,68(1):42-53. doi: 10.1016/j.survophthal.2022.08.004
[14]	Ponikowski P,Voors A A,Anker S D,et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J]. Eur J Heart,2016,18(8):891-975. doi: 10.1093/eurheartj/ehw128
[15]	Xu X,Feng Y,Jia Y,et al. Prognostic value of von willebrand factor and ADAMTS13 in patients with COVID-19: A systematic review and meta-analysis[J]. Thromb Res,2022,218:83-98. doi: 10.1016/j.thromres.2022.08.017
[16]	Roh J D,Kitchen R R,Guseh J S,et al. Plasma proteomics of COVID-19-associated cardiovascular complications: Implications for pathophysiology and therapeutics[J]. JACC Basic Transl Sci,2022,7(5):425-441. doi: 10.1016/j.jacbts.2022.01.013
[17]	Pagliari M T,Boscarino M,Cairo A,et al. ADAMTS13 activity,high VWF and FVIII levels in the pathogenesis of deep vein thrombosis[J]. Thromb Res,2021,197:132-137. doi: 10.1016/j.thromres.2020.10.037
[18]	曹磊,胡恩赑,李晓楠. vWF和vWF裂解酶水平对糖尿病肾病的影响[J]. 天津医药,2022,50(2):190-194. doi: 10.11958/20211643
[19]	Tschöpe C,Ammirati E,Bozkurt B,et al. Myocarditis and inflammatory cardiomyopathy: Current evidence and future directions[J]. Nat Rev Cardiol,2021,18(3):169-193. doi: 10.1038/s41569-020-00435-x
[20]	Everett B M,Cornel J H,Lainscak M,et al. Anti-inflammatory therapy with canakinumab for the prevention of hospitalization for heart failure[J]. Circulation,2019,139(10):1289-1299. doi: 10.1161/CIRCULATIONAHA.118.038010
[21]	Wójcik K,Bazan-Socha S,Celejewska-Wójcik N,et al. Decreased protein C activity,lower ADAMTS13 antigen and free protein S levels accompanied by unchanged thrombin generation potential in hospitalized COVID-19 patients[J]. Thromb Res,2023,223:80-86. doi: 10.1016/j.thromres.2023.01.016
[22]	Joly B S,Darmon M,Dekimpe C,et al. Imbalance of von Willebrand factor and ADAMTS13 axis is rather a biomarker of strong inflammation and endothelial damage than a cause of thrombotic process in critically ill COVID-19 patients[J]. J Thromb Haemost,2021,19(9):2193-2198. doi: 10.1111/jth.15445
[23]	Navise N H,Lammertyn L,Mokwatsi G G,et al. The association of von willebrand factor and its cleaving protease (ADAMTS13) with health behaviours in young black and white adults:The African-PREDICT study[J]. Biomarkers,2021,26(6):508-516. doi: 10.1080/1354750X.2021.1923063
[24]	Zhou S,Guo J,Zhao L,et al. ADAMTS13 inhibits oxidative stress and ameliorates progressive chronic kidney disease following ischaemia/reperfusion injury[J]. Acta Physiol,2021,231(3):e13586. doi: 10.1111/apha.13586
[25]	Hottz E D,Martins-Gonçalves R,Palhinha L,et al. Platelet-monocyte interaction amplifies thromboinflammation through tissue factor signaling in COVID-19[J]. Blood Adv,2022,6(17):5085-5099. doi: 10.1182/bloodadvances.2021006680
[26]	Lont S,Mohr F,Hecker M,et al. Role of CD40 ligand-mediated endothelial cell-monocyte interaction at atherosclerosis predilection sites[J]. Biochem Pharmacol,2022,206:115298. doi: 10.1016/j.bcp.2022.115298

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