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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | - |
dc.contributor.author | SOARES, Rosangela P. S. | - |
dc.contributor.author | BYDLOWSKI, Sergio P. | - |
dc.contributor.author | JATENE, Marcelo B. | - |
dc.contributor.author | HIRONAKA, Janete Ferreira | - |
dc.contributor.author | LOPES, Antonio Augusto | - |
dc.date.accessioned | 2013-09-23T16:36:11Z | - |
dc.date.available | 2013-09-23T16:36:11Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | CLINICS, v.68, n.4, p.531-536, 2013 | - |
dc.identifier.issn | 1807-5932 | - |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/1782 | - |
dc.description.abstract | OBJECTIVE: To analyze the preoperative plasma antigenic concentration and activity of von Willebrand factor and its main cleaving protease ADAMTS-13 in pediatric patients with cyanotic congenital heart disease undergoing surgical treatment and investigate possible correlations with postoperative bleeding. METHODS: Plasma antigenic concentrations (von Willebrand factor: Ag and ADAMTS-13: Ag) were measured using enzyme-linked immunoassays. Collagen-binding assays were developed to measure biological activities (von Willebrand factor: collagen binding and ADAMTS-13 activity). The multimeric structure of von Willebrand factor was analyzed using Western immunoblotting. Demographic, diagnostic, and general and specific laboratory data and surgery-related variables were subjected to univariate, bivariate, and multivariate analysis for the prediction of postoperative bleeding. RESULTS: Forty-eight patients were enrolled, with ages ranging from 9 months to 7.6 years (median 2.5 years). The plasma concentrations of von Willebrand factor: Ag and ADAMTS-13: Ag were decreased by 65 and 82%, respectively, in the patients compared with the controls (p<0.001). An increased density of low-molecular-weight fractions of von Willebrand factor, which are suggestive of proteolytic degradation (p = 0.0081), was associated with decreased ADAMTS-13 activity, which was likely due to ADAMTS-13 consumption (71% of controls, p = 0.0029) and decreased von Willebrand factor: collagen binding (76% of controls, p = 0.0004). Significant postoperative bleeding occurred in 13 patients. The preoperative ADAMTS-13 activity of <64.6% (mean level for the group), preoperative activated partial thromboplastin time, and the need for cardiopulmonary bypass were characterized as independent risk factors for postoperative bleeding, with respective hazard ratios of 22.35 (95% CI 1.69 to 294.79), 1.096 (95% CI 1.016 to 1.183), and 37.43 (95% CI 1.79 to 782.73). CONCLUSION: Low plasma ADAMTS-13 activity is a risk factor for postoperative bleeding in children with cyanotic congenital heart disease, particularly in children undergoing cardiopulmonary bypass. | - |
dc.description.sponsorship | Foundation for Research Support of the State of Sao Paulo (FAPESP), Sao Paulo, Brazil [05/59890-9] | - |
dc.language.iso | eng | - |
dc.publisher | HOSPITAL CLINICAS, UNIV SAO PAULO | - |
dc.relation.ispartof | Clinics | - |
dc.rights | openAccess | - |
dc.subject | Congenital Heart Disease | - |
dc.subject | Pediatric Cardiac Surgery | - |
dc.subject | Bleeding Tendency | - |
dc.subject | ADAMTS-13 | - |
dc.subject | von Willebrand factor (Cleaving Protease) | - |
dc.subject | Hemostasis | - |
dc.subject.other | von-willebrand-factor | - |
dc.subject.other | thrombotic thrombocytopenic purpura | - |
dc.subject.other | collagen-binding assay | - |
dc.subject.other | vonwillebrand-factor | - |
dc.subject.other | endothelial-cells | - |
dc.subject.other | platelet-aggregation | - |
dc.subject.other | cleaving protease | - |
dc.subject.other | tranexamic acid | - |
dc.subject.other | cardiac-surgery | - |
dc.subject.other | proteolysis | - |
dc.title | Decreased plasma ADAMTS-13 activity as a predictor of postoperative bleeding in cyanotic congenital heart disease | - |
dc.type | article | - |
dc.rights.holder | Copyright HOSPITAL CLINICAS, UNIV SAO PAULO | - |
dc.identifier.doi | 10.6061/clinics/2013(04)15 | - |
dc.identifier.pmid | 23778350 | - |
dc.subject.wos | Medicine, General & Internal | - |
dc.type.category | original article | - |
dc.type.version | publishedVersion | - |
hcfmusp.author.external | SOARES, Rosangela P. S.:Fundacao Prosangue Hemoctr Sao Paulo, Sao Paulo, Brazil | - |
hcfmusp.author.external | HIRONAKA, Janete Ferreira:Univ Sao Paulo, Fac Med, Hosp Clin, Heart Inst InCor,Dept Pediat Cardiol & Adult Cong, Sao Paulo, Brazil | - |
hcfmusp.description.beginpage | 531 | - |
hcfmusp.description.endpage | 536 | - |
hcfmusp.description.issue | 4 | - |
hcfmusp.description.volume | 68 | - |
hcfmusp.origem | WOS | - |
hcfmusp.origem.id | 2-s2.0-84878132579 | - |
hcfmusp.origem.id | WOS:000320002000015 | - |
hcfmusp.origem.id | SCIELO:S1807-59322013000400531 | - |
hcfmusp.publisher.city | SAO PAULO | - |
hcfmusp.publisher.country | BRAZIL | - |
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dc.description.index | MEDLINE | - |
hcfmusp.remissive.sponsorship | FAPESP | - |
hcfmusp.citation.scopus | 7 | - |
hcfmusp.scopus.lastupdate | 2024-04-12 | - |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - HC/InCor Artigos e Materiais de Revistas Científicas - LIM/11 Artigos e Materiais de Revistas Científicas - LIM/31 Artigos e Materiais de Revistas Científicas - ODS/03 |
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