SynthesisFrontiers in neurology2025
Association between plasma ADAMTS13 levels/activity and the risk of ischemic stroke and outcomes of recanalization therapies: a systematic review and meta-analysis.
Synthesis in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Large vWF (von Willebrand Factor) multimers are associated with ischemic stroke, and itsthrombogenicity is controlled by ADAMTS13 (a Disintegrin and Metalloprotease with repetitions in the ThromboSpond in motif). ADAMTS13 can cleave large vWF multimers into smaller, less procoagulant forms, preventing spontaneous platelet-thrombus formation. Extensive research has been conducted on the connection between ischemic stroke and ADAMTS13 activity as well as antigen levels, but got inconsistent conclusions. More recently, contradictory findings have been reported regarding the relationship between ADAMTS13 antigen levels or activity and recanalization therapy such as intravenous thrombolysis and mechanical thrombectomy. Methods: A thorough literature search was conducted from July 2th, 2001 to April 7th, 2025, utilizing various online databases including PubMed, Cochrane Library, Web of Science, and EMBASE. This meta-analysis aimed to synthesize observational evidence on the association between ADAMTS13 antigen or activity and stroke, and to evaluate its potential influence on recanalization outcomes following intravenous thrombolysis or mechanical thrombectomy. The pooled relative risk (RR) of stroke and the standardized mean difference (SMD) of the ADAMTS13 for stroke versus control subjects, as well as their corresponding 95% confidence interval (CI) were calculated. Eighteen studies with a total of 8,993 participants were included into this meta-analysis. Results: (1) ADAMTS13 activity was lower in patients with ischemic stroke when compared with controls, the SMD was -1.12 (95%CI: -1.20, -1.03, Conclusion: ADAMTS13 activity and ADAMTS13 plasma antigen levels were lower in patients with ischemic stroke. Reduced ADAMTS13 levels were significantly correlated with an increased risk of ischemic stroke. Meanwhile, baseline ADAMTS13 antigen levels were lower in patients with unfavorable outcomes in ischemic stroke patients who undergoing recanalization therapy. Notably, lower ADAMTS13 levels are associated with unfavorable early neurological outcome after recanalization therapy in acute ischemic stroke rather than 90-day prognosis. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251229650, Identifier: CRD420251229650.
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