Can the VWF to ADAMTS-13 Ratio Predict Mortality in Sepsis-Induced Coagulopathy? – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Feng Zhang et al, adding:
“Sepsis-induced coagulopathy: can the VWF to ADAMTS-13 ratio help identify patients at highest risk?
Sepsis disrupts blood clotting and damages the microvasculature. The balance between von Willebrand factor (VWF) and its cleaving protease ADAMTS-13 is thought to play a key role in microvascular thrombosis and poor outcomes, but its clinical value in sepsis-induced coagulopathy (SIC) has remained unclear.
A new prospective study in RPTH Journal investigates.
Key findings from 240 adult ICU patients with sepsis (Jilin University, 2025):
- 63.3% of patients met criteria for SIC
- SIC patients had lower ADAMTS-13 activity, higher VWF to ADAMTS-13 ratios, and higher 28-day mortality
- Among SIC patients, non-survivors had lower ADAMTS-13 levels and higher VWF to ADAMTS-13 ratios than survivors
- Both activity and antigen ratios were independently associated with 28-day mortality, with mortality increasing across ratio quartiles
However, the VWF/ADAMTS-13 ratios were not independent diagnostic markers for SIC once variables included in the SIC score were excluded
The VWF–ADAMTS-13 axis does not help diagnose SIC, but in established SIC it may help flag patients at higher risk of death, supporting its potential role in risk stratification and future biomarker-guided studies.”
Title: Prognostic value of von Willebrand factor and ADAMTS-13 in patients with sepsis-induced coagulopathy
Authors: Feng Zhang, Yuting Li, Yanhua Li, Dong Zhang
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